BackgroundAlthough a high incidence of cardiovascular disease (CVD) is observed among chronic kidney disease (CKD) patients in developed countries, limited information is available about CVD prevalence and risk factors in the Chinese CKD population. The Chinese Cohort of Chronic Kidney Disease (C-STRIDE) was established to investigate the prevalence and risk factors of CVD among Chinese CKD patients.MethodsParticipants with stage 1–4 CKD (18–74 years of age) were recruited at 39 clinical centers located in 28 cities from 22 provinces of China. At entry, the socio-demographic status, medical history, anthropometric measurements and lifestyle behaviors were documented, and blood and urine samples were collected. Estimated glomerular filtration rate (eGFR) was calculated by the CKD-EPI creatinine equation. CVD diagnosis was based on patient self-report and review of medical records by trained staff. A multivariable logistic regression model was used to estimate the association between risk factors and CVD.ResultsThree thousand four hundred fifty-nine Chinese patients with pre-stage 5 CKD were enrolled, and 3168 finished all required examinations and were included in the study. In total, 40.8% of the cohort was female, with a mean age of 48.21 ± 13.70 years. The prevalence of CVD was 9.8%, and in 69.1% of the CVD cases cerebrovascular disease was observed. Multivariable analysis showed that increasing age, lower eGFR, presence of hypertension, abdominal aorta calcification and diabetes were associated with comorbid CVD among CKD patients. The odds ratios and 95% confidence intervals for these risk factors were 3.78 (2.55–5.59) for age 45–64 years and 6.07 (3.89–9.47) for age ≥65 years compared with age <45 years; 2.07 (1.28–3.34) for CKD stage 3a, 1.66 (1.00–2.62) for stage 3b, and 2.74 (1.72–4.36) for stage 4 compared with stages 1 and 2; 2.57 (1.50–4.41) for hypertension, 1.82 (1.23–2.70) for abdominal aorta calcification, and 1.70 (1.30–2.23) for diabetes, respectively.ConclusionsWe reported the CVD prevalence among a CKD patient cohort and found age, hypertension, diabetes, abdominal aorta calcification and lower eGFR were independently associated with higher CVD prevalence. Prospective follow-up and longitudinal evaluations of CVD risk among CKD patients are warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0441-9) contains supplementary material, which is available to authorized users.

Background and Aims: The purpose of this study was to identify the characteristics and risk factors for cardiovascular calcification, and its relationship to prognosis, in patients with chronic kidney disease (CKD) stages 1–4.Methods: Cardiovascular calcification was evaluated at baseline by lateral abdominal radiography to detect abdominal aortic calcifications (AAC), and by echocardiogram to detect cardiac valvular calcifications (CVC), respectively. Demographic and laboratory data were collected and analyzed. Univariate and multivariable logistic regression model was used to explore the factors associated with the indicators of cardiovascular calcification, while Cox proportional hazards regression was used to examine the association between AAC/CVC and incidence of cardiovascular events and all-cause mortality.Results: A subgroup of 2,235 patients with measurement of AAC in the C-STRIDE study and a subgroup of 2,756 patients with CVC were included in the analysis. AAC was present in 206 patients (9.22%) and CVC was present in 163 patients (5.91%). Age, gender, history of cardiovascular diseases, smoking, hypertension, diabetes, levels of hemoglobin, low-density lipoprotein cholesterol, and uric acid were associated with prevalence of AAC, while only age, history of cardiovascular diseases, levels of serum albumin and low-density lipoprotein cholesterol were associated with prevalence of CVC (all p &lt; 0.05).Survival analyses showed that cardiovascular events and all-cause mortality were significantly greater in patients with AACor with CVC (all p-values for log-rank tests &lt;0.05). After adjustment for age, sex and estimated glomerular filtration rate (eGFR), AAC was associated with increased risk of all-cause mortality (hazard ratio = 1.67[95% confidence interval: 0.99, 2.79]), while CVC associated with that of cardiovascular events only among patients with comparatively normal eGFR (≥45 ml/min/1.73m2) (hazard ratio = 1.99 [0.98, 4.03]).Conclusion: Demographic and traditional cardiovascular risk factors were associated with cardiovascular calcification, especially AAC. AAC may be associated with risk of death for patients CKD of any severity, while CVC as a possible risk factor for cardiovascular disease only among those with mild to moderate CKD. Assessments of vascular calcification are need to be advanced to patients in the early and middle stages of chronic kidney disease and to initiate appropriate preventive measures earlier.

Henoch-Schönlein purpura (HSP) is a kind of allergic systemic necrotizing vasculitis. The incidence of renal involvement is 30%-50% in HSP patients. A recent national survey demonstrated that the treatment results of several randomized controlled trial (RCT) studies on Henoch-Schönlein purpura nephritis (HSPN) using Western medicine, such as glucocorticoids, immunosuppressive agents, and supportive therapy, were not satisfactory. Hence, there is a need to explore traditional Chinese medicine (TCM) syndrome elements and its related factors of HSPN in the real world to observe the clinical curative effect of TCM treatment. The Chinese Cohort Study of HSPN is the first national HSPN cohort in China. This study will enroll approximately 350 HSPN patients who are within 14-74 years old and will be followed up for 24 months. Questionnaires, body measurement, laboratory tests, and biomaterials will be collected at baseline, quarterly, and annually. The principal clinical outcomes of the study will include the summing up of TCM syndrome elements and its related factors of HSPN. At the same time, the clinical effect of TCM in alleviating the clinical uncomfortable symptoms of HSPN, proteinuria, and renal function will be observed and confirmed. This study will provide important evidences for the constitution and clinical effect of TCM syndrome elements and lay a foundation for further conducting RCT clinical research on the treatment of HSPN by TCM. At the same time, this will provide valuable information to establish clinical guidelines and healthcare policies for TCM treatment of HSPN in China.

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