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Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis
Patrick B Mark1, Juan J Carrero2,3, Kunihiro Matsushita4
1School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
European Heart Journal
|January 24, 2023
Summary
Cardiovascular disease (CVD) events significantly increase the risk of kidney failure with replacement therapy (KFRT). Heart failure events pose the highest risk for KFRT, underscoring the need for targeted management strategies.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease (CVD).
- The association between CVD and the future risk of kidney failure with replacement therapy (KFRT) is less understood.
Purpose of the Study:
- To investigate the impact of prevalent and incident cardiovascular disease events on the risk of kidney failure with replacement therapy (KFRT).
Main Methods:
- Analysis of a large cohort (25,903,761 individuals) from the CKD Prognosis Consortium.
- Time-varying exposure assessment for coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF).
- Evaluation of associations with kidney failure with replacement therapy (KFRT) outcomes.
Main Results:
- Both prevalent and incident CVD events were associated with increased KFRT risk.
- Incident heart failure (HF) showed the strongest association with KFRT (HR 46 within 3 months).
- Hazard ratios for KFRT were highest within 3 months post-CVD incidence, declining over 3 years.
Conclusions:
- Incident cardiovascular disease events independently elevate future KFRT risk.
- Heart failure events present the most significant risk for subsequent KFRT.
- Urgent need for optimal strategies to manage KFRT risk following CVD events.
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