Cardiovascular events and mortality in chronic kidney disease (stages I-IV)

Area of Science:

• Nephrology
• Cardiology
• Internal Medicine

Background:

• Cardiovascular events (CV) are the leading cause of mortality in patients with chronic kidney disease (CKD).
• Predicting CV events and mortality in early-stage CKD (stages 1-4) is critical for patient management.
• Identifying independent predictors is essential for targeted interventions.

Purpose of the Study:

• To determine the independent predictors of cardiovascular events and mortality in patients with chronic kidney disease stages 1-4.
• To evaluate the predictive power of both classic and emerging cardiovascular risk markers.

Main Methods:

• A prospective study involving 218 CKD patients (62% male, median age 69 years).
• Collection of baseline demographic data, cardiovascular risk factors, and biochemical values.
• Prospective follow-up for a median of 38 months to record new CV events and deaths.

Main Results:

• During follow-up, 50 patients experienced a composite endpoint (37 CV events, 13 non-CV deaths).
• Initial analysis associated final events with male sex, smoking, diabetes, prior CV history, low diastolic blood pressure, low glomerular filtration, high urine albumin/creatinine ratio, elevated troponin T, BNP, CRP, and low hemoglobin.
• Multivariate analysis identified male sex, diabetes mellitus, previous CV event, and lower glomerular filtration as independent predictors.

Conclusions:

• Male sex, diabetes mellitus, prior cardiovascular events, and reduced glomerular filtration are independent predictors of cardiovascular events or death in CKD patients.
• The study did not establish the superiority of emerging cardiovascular risk markers over traditional ones in this cohort.