Janus Face of Coronary Artery Disease and Chronic Kidney Disease

Barrows, Ian R.; Raj, Dominic S.

doi:10.1161/jaha.116.003596

Cited by 6 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are consistent with previous observations that associations of CKD are largely independent of CVD. 13 Our findings therefore support the importance of CVD prevention in patients with CKD, as well as the prevention of CKD in patients with CVD, 35,37,38 and suggest that prevention of CKD and CVD may play equally important roles in decreasing the disease burden in patients with HTN. This suggests that prevention of both CKD and CVD may play an equally important role in decreasing the disease burden in patients with HTN.…”

Section: Discussionsupporting

confidence: 68%

Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients

Wan¹,

Yu²,

Chin³

et al. 2019

JASN

View full text Add to dashboard Cite

BackgroundThe relative effects of combinations of CKD, heart disease, and stroke on risk of mortality, direct medical costs, and life expectancy are unknown.MethodsIn a retrospective cohort study of 506,849 Chinese adults in Hong Kong with hypertension, we used Cox regressions to examine associations between all-cause mortality and combinations of moderate CKD (eGFR of 30–59 ml/min per 1.73 m2), severe CKD (eGFR of 15–29 ml/min per 1.73 m2), heart disease (coronary heart disease or heart failure), and stroke, and modeling to estimate annual public direct medical costs and life expectancy.ResultsOver a median follow-up of 5.8 years (2.73 million person-years), 55,666 deaths occurred. Having an increasing number of comorbidities was associated with incremental increases in mortality risk and medical costs and reductions in life expectancy. Compared with patients who had neither CKD nor cardiovascular disease, patients with one, two, or three conditions (heart disease, stroke, and moderate CKD) had relative risk of mortality increased by about 70%, 160%, and 290%, respectively; direct medical costs increased by about 70%, 160%, and 280%, respectively; and life expectancy at age 60 years decreased by about 5, 10, and 15 years, respectively. Burdens were higher with severe CKD.ConclusionsThis study demonstrated extremely high mortality risk and medical cost increases for severe CKD, exceeding the combined effects from heart disease and stroke. Mortality risks and costs for moderate CKD, heart disease, and stroke were similar individually and roughly multiplicative for any combination. These findings suggest that to reduce mortality and health care costs in patients with hypertension, CKD prevention and intervention merits priority equal to that of cardiovascular disease.

show abstract

Section: Discussionsupporting

confidence: 68%

Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients

Wan¹,

Yu²,

Chin³

et al. 2019

JASN

View full text Add to dashboard Cite

show abstract

“…Recently, the Trial to Reduce Cardiovascular Events with Aranesp Therapy has demonstrated that in type 2 diabetic patients with CKD and anemia, history of coronary artery disease was associated with progression to dialysis [8]. Thus, “there is a bidirectional relationship between reduced GFR and CVD, and the magnitude of the problem is underappreciated” [9]. Japanese Society of Nephrology recommended the same ABC targets as Japan Diabetes Society guidelines in “Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease in 2012” [10].…”

Section: Introductionmentioning

confidence: 99%

Associations of ABC (Hemoglobin A1c, Blood Pressure and Low-Density Lipoprotein Cholesterol) Goal Achievement With Chronic Kidney Disease in Type 2 Diabetic Patients With Preserved Kidney Function

et al. 2019

View full text Add to dashboard Cite

BackgroundWe investigated cross-sectional and prospective associations of ABC (hemoglobin A1c (HbA1c), blood pressure and low-density lipoprotein cholesterol) goal attainment with chronic kidney disease. Cross-sectional association with carotid intima-media thickness (IMT) was evaluated as well.MethodsPrevalence of low estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2) and albuminuria (urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g) were assessed at baseline and after a median follow-up of 6.0 years in 168 patients with type 2 diabetes with preserved kidney function (aged 62.3 years, 53.6% men). Carotid IMT was measured at baseline only.ResultsAt baseline, 47 (28.0%), 45 (26.8%), 63 (37.5%) and 13 (7.7%) patients achieved triple-goal, dual-goal, single-goal and no-goal, respectively. Achieving more ABC targets was associated with lower log ACR (P < 0.01), lower percentage of albuminuria (P = 0.02), and lower carotid IMT (P < 0.01) at baseline. Over 6.0 years, eGFR decreased from 76 ± 16 to 67 ± 18 mL/min/1.73 m2 (P < 0.01) whereas ACR levels did not change. There were 32 patients with incident reduced eGFR, eight with GFR stage progression, 15 with progression of albuminuric stages and five with doubling of ACR within the microalbuminuric range. Achieving more ABC targets decreased the percentage of deterioration of GFR stages (30.8%, 28.6%, 24.4% and 14.9%, respectively, P = 0.01). Achieving two or more (8.9% and 8.5%, respectively) compared with one or less ABC targets (15.4% and 15.9%, respectively) was associated with less deterioration of albuminuria (P < 0.001). Although achieving more ABC targets was associated with lower annual decline in eGFR, the difference was not significant.ConclusionsABC goal achievement has shown cross-sectional and prospective associations with deterioration of chronic kidney disease in type 2 diabetic patients with preserved kidney function. Cross-sectional association with carotid IMT has been demonstrated as well. Reaching more ABC treatment targets may be important for preventing adverse renal outcomes.

show abstract

“…Tais eventos estão associados a um processo contínuo de reduções discretas do ritmo de filtração glomerular (RFG) e permanecem influenciando o prognóstico até os estágios mais avançados da enfermidade [5] . Quando se utiliza a RFG como variável contínua, a redução de 10 mL/min/1,73m² aumenta em 5% a 6% a incidência de eventos cardiovasculares (CV), tais como morte e infarto [10,11] .…”

Section: Introductionunclassified

Efeito da filtração glomerular em pacientes diabéticos com doença arterial coronariana submetidos aos tratamentos cirúrgico, percutâneo ou clínico: dez anos de seguimento

Batista¹

View full text Add to dashboard Cite

show abstract

Janus Face of Coronary Artery Disease and Chronic Kidney Disease

Cited by 6 publications

References 21 publications

Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients

Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients

Associations of ABC (Hemoglobin A1c, Blood Pressure and Low-Density Lipoprotein Cholesterol) Goal Achievement With Chronic Kidney Disease in Type 2 Diabetic Patients With Preserved Kidney Function

Efeito da filtração glomerular em pacientes diabéticos com doença arterial coronariana submetidos aos tratamentos cirúrgico, percutâneo ou clínico: dez anos de seguimento

Contact Info

Product

Resources

About