Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study

Patrick B Mark; Juan Jesus Carrero; Kunihiro Matsushita; Yingying  Sang; Shoshana H Ballew; Morgan E Grams; Josef Coresh; Aditya Surapaneni; Nigel J Brunskill; John Chalmers; Lili Chan; Alex R  Chang; Rajkumar  Chinnadurai; Gabriel Chodick; Massimo  Cirillo; Dick de Zeeuw; Marie Evans; Amit X Garg; Orlando M  Gutierrez; Hiddo JL  Heerspink; Gunnar H Heine; William G  Herrington; Junichi  Ishigami; Florian  Kronenberg; Jun Young Lee; Adeera Levin; Rupert W Major; Angharad Marks; Girish N  Nardkarni; David MJ  Naimark; Christoph Nowak; Mahboob Rahman; Charumathi Sabanayagam; Mark Sarnak; Simon Sawhney; Markus P  Schneider; Varda Shalev; Jung-Im Shim; Moneeza K  Siddiqui; Nikita Stempniewicz; Keiichi Sumida; Jose M. Valdivielso; Jan van den Brand; Angela Yee Moon Wang; David C Wheeler; Lihua Zhang; Frank LJ  Visseren; Benedicte Stengel

doi:10.1093/eurheartj/ehac825

Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study

Patrick B Mark, Juan Jesus Carrero, Kunihiro Matsushita, Yingying Sang, Shoshana H Ballew^* (Corresponding Author), Morgan E Grams, Josef Coresh, Aditya Surapaneni, Nigel J Brunskill, John Chalmers, Lili Chan, Alex R Chang, Rajkumar Chinnadurai, Gabriel Chodick, Massimo Cirillo, Dick de Zeeuw, Marie Evans, Amit X Garg, Orlando M Gutierrez, Hiddo JL HeerspinkGunnar H Heine, William G Herrington, Junichi Ishigami, Florian Kronenberg, Jun Young Lee, Adeera Levin, Rupert W Major, Angharad Marks, Girish N Nardkarni, David MJ Naimark, Christoph Nowak, Mahboob Rahman, Charumathi Sabanayagam, Mark Sarnak, Simon Sawhney, Markus P Schneider, Varda Shalev, Jung-Im Shim, Moneeza K Siddiqui, Nikita Stempniewicz, Keiichi Sumida, Jose M. Valdivielso, Jan van den Brand, Angela Yee Moon Wang, David C Wheeler, Lihua Zhang, Frank LJ Visseren, Benedicte Stengel

^*Corresponding author for this work

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Abstract

AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT).

METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence.

CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

Original language	English
Article number	ehac825
Pages (from-to)	1157-1166
Number of pages	9
Journal	European Heart Journal
Volume	44
Issue number	13
Early online date	24 Jan 2023
DOIs	https://doi.org/10.1093/eurheartj/ehac825
Publication status	Published - 1 Apr 2023

Bibliographical note

Funding
The CKD Prognosis Consortium (CKD-PC) Data Coordinating Centre is funded in part by a programme grant from the US National Kidney Foundation and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100446). A variety of sources have supported enrolment and data collection including laboratory measurements, and follow-up in the collaborating cohorts of the CKD-PC. These funding sources include government agencies such as national institutes of health and medical research councils as well as foundations and industry sponsors listed in supplementary material online, eAppendix 3.

© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].

Data Availability Statement

Under agreement with the participating cohorts, CKD-PC cannot share individual data with third parties. Inquiries regarding specific analyses should be made to [email protected]. Investigators may approach the original cohorts regarding their own policies for data sharing (e.g. https://sites.cscc.unc.edu/aric/distribution-agreements for the Atherosclerosis Risk in Communities Study).

Keywords

Cardiovascular disease
Heart failure
Kidney Failure
eGFR
Albuminura

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/eurheartj/ehac825

Mark_etal_EHJ_Major_Cardiovascular_Events_AAM
This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal following peer review. The version of record Patrick B Mark.etal, Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study, European Heart Journal, Volume 44, Issue 13, 1 April 2023, Pages 1157–1166, is available online at https://doi.org/10.1093/eurheartj/ehac825
Accepted author manuscript, 2.98 MBLicence: Unspecified

Cite this

Mark, P. B., Carrero, J. J., Matsushita, K., Sang, Y., Ballew, S. H., Grams, M. E., Coresh, J., Surapaneni, A., Brunskill, N. J., Chalmers, J., Chan, L., Chang, A. R., Chinnadurai, R., Chodick, G., Cirillo, M., de Zeeuw, D., Evans, M., Garg, A. X., Gutierrez, O. M., ... Stengel, B. (2023). Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study. European Heart Journal, 44(13), 1157-1166. Article ehac825. https://doi.org/10.1093/eurheartj/ehac825

Mark, PB, Carrero, JJ, Matsushita, K, Sang, Y, Ballew, SH, Grams, ME, Coresh, J, Surapaneni, A, Brunskill, NJ, Chalmers, J, Chan, L, Chang, AR, Chinnadurai, R, Chodick, G, Cirillo, M, de Zeeuw, D, Evans, M, Garg, AX, Gutierrez, OM, Heerspink, HJL, Heine, GH, Herrington, WG, Ishigami, J, Kronenberg, F, Lee, JY, Levin, A, Major, RW, Marks, A, Nardkarni, GN, Naimark, DMJ, Nowak, C, Rahman, M, Sabanayagam, C, Sarnak, M, Sawhney, S, Schneider, MP, Shalev, V, Shim, J-I, Siddiqui, MK, Stempniewicz, N, Sumida, K, Valdivielso, JM, van den Brand, J, Wang, AYM, Wheeler, DC, Zhang, L, Visseren, FLJ & Stengel, B 2023, 'Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study', European Heart Journal, vol. 44, no. 13, ehac825, pp. 1157-1166. https://doi.org/10.1093/eurheartj/ehac825

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title = "Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study",

abstract = "AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT).METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence.CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.",

keywords = "Cardiovascular disease, Heart failure, Kidney Failure, eGFR, Albuminura",

author = "Mark, {Patrick B} and Carrero, {Juan Jesus} and Kunihiro Matsushita and Yingying Sang and Ballew, {Shoshana H} and Grams, {Morgan E} and Josef Coresh and Aditya Surapaneni and Brunskill, {Nigel J} and John Chalmers and Lili Chan and Chang, {Alex R} and Rajkumar Chinnadurai and Gabriel Chodick and Massimo Cirillo and {de Zeeuw}, Dick and Marie Evans and Garg, {Amit X} and Gutierrez, {Orlando M} and Heerspink, {Hiddo JL} and Heine, {Gunnar H} and Herrington, {William G} and Junichi Ishigami and Florian Kronenberg and Lee, {Jun Young} and Adeera Levin and Major, {Rupert W} and Angharad Marks and Nardkarni, {Girish N} and Naimark, {David MJ} and Christoph Nowak and Mahboob Rahman and Charumathi Sabanayagam and Mark Sarnak and Simon Sawhney and Schneider, {Markus P} and Varda Shalev and Jung-Im Shim and Siddiqui, {Moneeza K} and Nikita Stempniewicz and Keiichi Sumida and Valdivielso, {Jose M.} and {van den Brand}, Jan and Wang, {Angela Yee Moon} and Wheeler, {David C} and Lihua Zhang and Visseren, {Frank LJ} and Benedicte Stengel",

note = "Funding The CKD Prognosis Consortium (CKD-PC) Data Coordinating Centre is funded in part by a programme grant from the US National Kidney Foundation and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100446). A variety of sources have supported enrolment and data collection including laboratory measurements, and follow-up in the collaborating cohorts of the CKD-PC. These funding sources include government agencies such as national institutes of health and medical research councils as well as foundations and industry sponsors listed in supplementary material online, eAppendix 3. {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].",

year = "2023",

month = apr,

day = "1",

doi = "10.1093/eurheartj/ehac825",

language = "English",

volume = "44",

pages = "1157--1166",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "OXFORD UNIV PRESS",

number = "13",

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TY - JOUR

T1 - Major cardiovascular events and subsequent risk of kidney failure with replacement therapy

T2 - a CKD Prognosis Consortium study

AU - Mark, Patrick B

AU - Carrero, Juan Jesus

AU - Matsushita, Kunihiro

AU - Sang, Yingying

AU - Ballew, Shoshana H

AU - Grams, Morgan E

AU - Coresh, Josef

AU - Surapaneni, Aditya

AU - Brunskill, Nigel J

AU - Chalmers, John

AU - Chan, Lili

AU - Chang, Alex R

AU - Chinnadurai, Rajkumar

AU - Chodick, Gabriel

AU - Cirillo, Massimo

AU - de Zeeuw, Dick

AU - Evans, Marie

AU - Garg, Amit X

AU - Gutierrez, Orlando M

AU - Heerspink, Hiddo JL

AU - Heine, Gunnar H

AU - Herrington, William G

AU - Ishigami, Junichi

AU - Kronenberg, Florian

AU - Lee, Jun Young

AU - Levin, Adeera

AU - Major, Rupert W

AU - Marks, Angharad

AU - Nardkarni, Girish N

AU - Naimark, David MJ

AU - Nowak, Christoph

AU - Rahman, Mahboob

AU - Sabanayagam, Charumathi

AU - Sarnak, Mark

AU - Sawhney, Simon

AU - Schneider, Markus P

AU - Shalev, Varda

AU - Shim, Jung-Im

AU - Siddiqui, Moneeza K

AU - Stempniewicz, Nikita

AU - Sumida, Keiichi

AU - Valdivielso, Jose M.

AU - van den Brand, Jan

AU - Wang, Angela Yee Moon

AU - Wheeler, David C

AU - Zhang, Lihua

AU - Visseren, Frank LJ

AU - Stengel, Benedicte

N1 - Funding The CKD Prognosis Consortium (CKD-PC) Data Coordinating Centre is funded in part by a programme grant from the US National Kidney Foundation and the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100446). A variety of sources have supported enrolment and data collection including laboratory measurements, and follow-up in the collaborating cohorts of the CKD-PC. These funding sources include government agencies such as national institutes of health and medical research councils as well as foundations and industry sponsors listed in supplementary material online, eAppendix 3. © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: [email protected].

PY - 2023/4/1

Y1 - 2023/4/1

N2 - AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT).METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence.CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

AB - AIMS: Chronic kidney disease (CKD) increases risk of cardiovascular disease (CVD). Less is known about how CVD associates with future risk of kidney failure with replacement therapy (KFRT).METHODS AND RESULTS: The study included 25 903 761 individuals from the CKD Prognosis Consortium with known baseline estimated glomerular filtration rate (eGFR) and evaluated the impact of prevalent and incident coronary heart disease (CHD), stroke, heart failure (HF), and atrial fibrillation (AF) events as time-varying exposures on KFRT outcomes. Mean age was 53 (standard deviation 17) years and mean eGFR was 89 mL/min/1.73 m2, 15% had diabetes and 8.4% had urinary albumin-to-creatinine ratio (ACR) available (median 13 mg/g); 9.5% had prevalent CHD, 3.2% prior stroke, 3.3% HF, and 4.4% prior AF. During follow-up, there were 269 142 CHD, 311 021 stroke, 712 556 HF, and 605 596 AF incident events and 101 044 (0.4%) patients experienced KFRT. Both prevalent and incident CVD were associated with subsequent KFRT with adjusted hazard ratios (HRs) of 3.1 [95% confidence interval (CI): 2.9-3.3], 2.0 (1.9-2.1), 4.5 (4.2-4.9), 2.8 (2.7-3.1) after incident CHD, stroke, HF and AF, respectively. HRs were highest in first 3 months post-CVD incidence declining to baseline after 3 years. Incident HF hospitalizations showed the strongest association with KFRT [HR 46 (95% CI: 43-50) within 3 months] after adjustment for other CVD subtype incidence.CONCLUSION: Incident CVD events strongly and independently associate with future KFRT risk, most notably after HF, then CHD, stroke, and AF. Optimal strategies for addressing the dramatic risk of KFRT following CVD events are needed.

KW - Cardiovascular disease

KW - Heart failure

KW - Kidney Failure

KW - eGFR

KW - Albuminura

U2 - 10.1093/eurheartj/ehac825

DO - 10.1093/eurheartj/ehac825

M3 - Article

C2 - 36691956

SN - 0195-668X

VL - 44

SP - 1157

EP - 1166

JO - European Heart Journal

JF - European Heart Journal

IS - 13

M1 - ehac825

ER -

Major cardiovascular events and subsequent risk of kidney failure with replacement therapy: a CKD Prognosis Consortium study

Abstract

Bibliographical note

Data Availability Statement

Keywords

UN SDGs

Access to Document

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