Le réseau

Couchoud, Cécile; Lassalle, Mathilde; Jacquelinet, Christian

doi:10.1016/s1769-7255(13)70037-3

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…All the considered events occurred before RRT. RRT was defined in the present study as kidney dysfunction requiring initiation of chronic dialysis or preemptive transplantation (as identified from medical records or by linking to the French National Kidney Failure Registry) [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Urea levels and cardiovascular disease in patients with chronic kidney disease

Laville

Couturier

Lambert

et al. 2022

Nephrology Dialysis Transplantation

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Background Elevated serum urea levels are common in moderate-to-advanced CKD. Several studies have shown that urea is a direct and indirect uremic toxin, especially with regard to cardiovascular disease. We sought to determine whether serum urea levels are associated with adverse cardiovascular events and death before renal replacement therapy (RRT) in patients with CKD. Methods CKD-REIN is a prospective cohort of CKD nephrology outpatients not receiving maintenance dialysis. The 2507 patients included in the analysis were divided into three groups according to the baseline serum urea level (T1 < 10.5, T2:10.5 to 15.1, and T3 ≥ 15.1 mmol/L). Cox proportional hazard models were used to estimate hazard ratios (HRs) for first atheromatous or nonatheromatous cardiovascular (CV) events, and all-cause mortality before RRT. The models were adjusted for baseline comorbidities, laboratory data, and medications. Findings Of the 2507 included patients (median [interquartile range (IQR)] age: 69[61–77]; mean (standard deviation) eGFR 33.5(11.6) mL/min/1.73 m²), 54% had a history of cardiovascular disease. After multiple adjustments for cardiovascular risk factors (including eGFR), patients in T3 had a higher risk of atheromatous and nonatheromatous cardiovascular events than patient in T1 (n events = 451, HR[95%CI]: 1.93[1.39–2.69]). The adjusted HRs for death before RRT (n events = 407) were 1.31[0.97; 1.76] and 1.73[1.22; 2.45] for patients T2 and those in T3, respectively. Interpretation Our data suggested that urea is a predictor of cardiovascular outcomes beyond CV risk factors including eGFR.

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Section: Methodsmentioning

confidence: 99%