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Immunoglobulin A nephropathy and ischemic heart disease: a nationwide population-based cohort study

Simon Jarrick1,2, Sigrid Lundberg3,4, Johan Sundström5,6

  • 1Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

BMC Nephrology
|May 6, 2021
PubMed

Insights

Patients with immunoglobulin A nephropathy (IgAN) have an 86% increased risk of ischemic heart disease (IHD). This large Swedish study highlights the significant cardiovascular burden associated with IgAN, emphasizing the need for proactive cardiac monitoring.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) is associated with cardiovascular disease, particularly ischemic heart disease (IHD).
  • Large-scale population data on IHD risk in patients with immunoglobulin A nephropathy (IgAN) are limited.
  • IgAN is a common primary glomerulonephritis, often leading to CKD.

Purpose of the Study:

  • To investigate the absolute and relative risks of IHD in a population-based cohort of patients diagnosed with IgAN.
  • To quantify the increased risk of IHD associated with IgAN compared to the general population, siblings, and spouses.

Main Methods:

  • A nationwide, population-based cohort study in Sweden utilizing register data.
  • Inclusion of 3945 patients with biopsy-verified IgAN and 19,272 matched reference individuals.
  • Secondary analyses included sibling (3039 IgAN patients vs. 6729 siblings) and spousal (2377 couples) comparisons to mitigate confounding.
  • Cox regression analysis was used to estimate adjusted hazard ratios (HRs) for IHD and end-stage renal disease (ESRD).

Main Results:

  • During a mean follow-up of 14.1 years, 9.4% of IgAN patients developed IHD compared to 5.6% of reference individuals.
  • The adjusted HR for IHD in IgAN patients was 1.86 (95% CI: 1.63-2.13), indicating an 86% increased risk.
  • Increased IHD risk was also observed in sibling (HR: 2.07) and spousal (HR: 1.91) analyses.
  • Higher IHD risk was noted in the first year post-diagnosis and in patients born outside Nordic countries.

Conclusions:

  • Patients with IgAN face a significantly elevated risk of developing future ischemic heart disease.
  • The findings underscore the critical link between IgAN and cardiovascular complications.
  • This study highlights the importance of cardiovascular risk assessment and management in individuals with IgAN.
Abstract

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