Using CHADS₂ and CHA₂DS₂-VASc scores for mortality prediction in patients with chronic kidney disease

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Chronic kidney disease (CKD) presents a significant public health challenge, linked to elevated morbidity and mortality.
• Identifying high-risk CKD patients is crucial for improving long-term patient outcomes.
• CHADS₂ and CHA₂DS₂-VASc scores are established for stroke risk in atrial fibrillation but their utility in CKD mortality prediction is unexplored.

Purpose of the Study:

• To investigate the predictive value of CHADS₂ and CHA₂DS₂-VASc scores for cardiovascular (CV) and all-cause mortality in patients with CKD.
• To compare the predictive performance of CHADS₂ and CHA₂DS₂-VASc scores in this population.

Main Methods:

• A longitudinal study involving 437 CKD patients.
• Calculation of CHADS₂ and CHA₂DS₂-VASc scores for all participants.
• Long-term follow-up for CV and all-cause mortality, with a median of 91 months.

Main Results:

• Both CHADS₂ and CHA₂DS₂-VASc scores were significant independent predictors of CV and all-cause mortality in multivariate analysis (P < 0.001).
• The CHA₂DS₂-VASc score demonstrated superior additive predictive value for all-cause mortality compared to the CHADS₂ score when added to a basic model (P = 0.031).
• A total of 66 CV deaths and 165 all-cause deaths were recorded during the follow-up period.

Conclusions:

• CHADS₂ and CHA₂DS₂-VASc scores are valuable tools for predicting long-term CV and all-cause mortality in CKD patients.
• The CHA₂DS₂-VASc score exhibits enhanced predictive capability for all-cause mortality in CKD patients compared to the CHADS₂ score.
• These scores can aid in identifying CKD patients at higher risk of mortality, facilitating targeted interventions.