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Impact of cardiovascular events on mortality and progression of renal dysfunction in a Queensland CKD cohort
Author(s) -
Jeyaruban Andrew,
Hoy Wendy,
Cameron Anne,
Healy Helen,
Wang Zaimin,
Zhang Jianzhen,
Mallett Andrew
Publication year - 2020
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13745
Subject(s) - medicine , kidney disease , renal function , cohort , retrospective cohort study , electronic health record , stroke (engine) , renal replacement therapy , cohort study , disease , health care , mechanical engineering , engineering , economics , economic growth
Aim Cardiovascular events (CVE) are common co‐morbidities amongst patients with chronic kidney disease (CKD). The impact of CVE on the subsequent pattern and rate of deterioration of kidney function is not well described. Methods A retrospective cohort study of 1123 Royal Brisbane and Women's Hospital patients enrolled in the CKD.QLD registry from May 2011 to August 2017 was undertaken. Participants CVE data and renal function (eGFR CKD‐EPI) were extracted from clinical records. Participants who ultimately started kidney replacement therapy (KRT) were imputed an eGFR of 8 mL/min/1.73 m 2 at the date of the first KRT treatment. Annualized percentage delta eGFR was used to explore the association between CVE and rate of renal deterioration. Mortality was ascertained through electronic health records. Results There were 235 CVE events amongst 222 participants over a period of 6 years. One hundred and forty‐four participants experienced ischaemic heart disease (IHD), 51 participants had stroke, 40 participants had peripheral vascular disease (PVD) and 13 participants had more than one event. CVE were associated with significantly shorter time to death in participants who experienced one CVE compared with those without a CVE (1901.2 days vs 2259 days [ P < .05]). However, there was no significant change in the absolute mean delta eGFR between participants with CVE and without CVE after adjustment for age (3.8 mL/min/1.73 m 2 vs 3.8 mL/min/1.73 m 2 [ P = .9]). Furthermore, there was no significant difference in the progression to KRT in participants with CVE compared with participants without CVE (1315 days and 1052 days ( P = .46). Conclusion Cardiovascular events are associated with increased mortality in the CKD cohort. They were not associated with accelerated deterioration of kidney function.