Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population

Lim, Cynthia Ciwei; Teo, Boon Wee; Ong, Peng Guan; Cheung, Carol Y.; Lim, Su Chi; Chow, Khuan Yew; Meng, Chan; Lee, Jeannette; Tai, E. Shyong; Wong, Tien Yin; Sabanayagam, Charumathi

doi:10.1177/2047487314536873

Cited by 58 publications

(61 citation statements)

References 36 publications

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“…The eGFR range in this study group was 25 to 188 mL/min/1.73 m2 with only 5.9% patients having an eGFR <45. The association of eGFR <45 with increased cardiovascular risk has been observed previously, but the minority of patients in this study lying in this range might explain why eGFR or other renal function markers did not interact with uACR as a predictor of events in this dataset. Albuminuria may be an earlier renal sign of increased cardiovascular event risk than eGFR, because it was observed in this population with mostly preserved kidney function.…”

Section: Discussionsupporting

confidence: 65%

Relationship of mildly increased albuminuria and coronary artery revascularization outcomes in patients with diabetes

Siddique

Murphy

Naeem

et al. 2018

Cathet Cardio Intervent

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Background The aim of this study was to examine the relationship of albuminuria to cardiovascular disease outcomes in diabetic patients undergoing treatment for stable coronary artery disease. Methods and results We analyzed data from 2176 participants of the Bypass Angioplasty Revascularization Investigation in type‐2 diabetes (BARI‐2D) trial, a randomized clinical trial comparing Percutaneous coronary intervention/Coronary artery bypass grafting (PCI/CABG) to medical therapy for people with diabetes. The population was stratified by baseline spot urine albumin–creatinine ratio (uACR) into normal (uACR <10 mg/g), mildly (uACR ≥10 mg/g < 30 mg/g), moderately (uACR ≥30 mg/g < 300 mg/g) and severely increased (uACR ≥300 mg/g) groups, and outcomes compared between groups. Death, myocardial infarction (MI) and/or stroke were experienced by 489 patients at a mean follow‐up of 4.3 ± 1.5 years. Compared with normal uACR, mildly increased uACR was associated with a 1.4 times (P = 0.042) increase in all‐cause mortality. Additionally, nonwhites with type‐II diabetes and stable coronary artery disease who had mildly increased albuminuria had a Hazard ratio (HR) of 3.3 times (P = 0.028) for cardiovascular death, 3.1 times for (P = 0.002) all‐cause mortality, and two times for (P = 0.015) MI during follow‐up. Conclusions Mildly increased albuminuria is a significant predictor of all‐cause mortality in those with type‐II diabetes mellitus and stable coronary artery disease, as well as for cardiovascular events those who are nonwhites.

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Section: Discussionsupporting

confidence: 65%

Relationship of mildly increased albuminuria and coronary artery revascularization outcomes in patients with diabetes

Siddique

Murphy

Naeem

et al. 2018

Cathet Cardio Intervent

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“…The OR s of CVD and all-cause mortality were 1.54 and 2.21, respectively, in patients with eGFRs of <45 versus ≥60 ml·min −1 ·1.73 m −2 , and 2.81 and 2.34, respectively, in patients with UACRs of ≥300 versus <30 mg/g·Cr. [21] In an earlier study in the general population, a 2-fold increase in urine albumin concentration was found to be associated with a 1.29-fold increase in the risk for cardiovascular mortality. [22] It was reported that cardiovascular mortality was found to be two to three times higher in patients with Stage 3 or higher CKD than in individuals without renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Association of Chronic Kidney Disease with Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus

Sun

et al. 2017

Chinese Medical Journal

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Background:Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD). However, the association between CKD and CVD risk in patients with type 2 diabetes mellitus (T2DM) in China has not yet been well investigated. This study aimed to determine the association of CKD with the risks of coronary heart disease (CHD) and stroke in a Chinese population with T2DM.Methods:A total of 1401 inpatients with T2DM at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2008 and November 2013 were included in this study. The CKD-Epidemiology Collaboration equation for Asians was used to classify CKD. The UK Prospective Diabetes Study risk engine was used to estimate the risks of CHD and stroke.Results:CHD risk was significantly increased with CKD stage (20.1%, 24.8%, and 34.3% in T2DM patients with no CKD, CKD Stage 1–2, and Stage 3–5, respectively; P < 0.001 for all). The stroke risk was also increased with CKD stage (8.6%, 12.7%, and 25.4% in T2DM patients with no CKD, CKD Stage 1–2, and Stage 3–5, respectively; P < 0.001 for all). Compared with no-CKD group, the odds ratios (ORs) for high CHD risk were 1.7 (P < 0.001) in the CKD Stage 1–2 group and 3.5 (P < 0.001) in the CKD Stage 3–5 group. The corresponding ORs for high stroke risk were 1.9 (P < 0.001) and 8.2 (P < 0.001), respectively.Conclusion:In patients with T2DM, advanced CKD stage was associated with the increased risks of CHD and stroke.

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“…We have previously used the database for other studies. 21,22 MI was defined as either (1) definitive or clinical MI; or (2) death cases signed up by pathologists or physicians as MI, with or without necropsy done. Incident MI was identified by linkage with a subset of the National Registry of Diseases Office database: the Singapore Myocardial Infarction Registry, which captures all MI diagnosed and coded with International Classification of Diseases 9th Revision (ICD-9) 410 in all hospitals.…”

Section: This Ismentioning

confidence: 99%

“…We used the 2011 Singapore Population as the standard population for comparison. 22 Specifically, we used the Singapore Male population (consisting of 48.8% of the total Singapore population) for standardizing the male participants, and the Singapore Female population (consisting of 52.2% of the total Singapore population) for standardizing the female participants. 26 Age strata-specific (5-year age group) IR were calculated by weighing the proportions of the corresponding age strata in the population census.…”

Section: This Ismentioning

confidence: 99%

Incidence of Myocardial Infarction, Stroke, and Death in Patients With Age-Related Macular Degeneration Treated With Intravitreal Anti–Vascular Endothelial Growth Factor Therapy

Tan

Ong

et al. 2015

American Journal of Ophthalmology

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Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population

Cited by 58 publications

References 36 publications

Relationship of mildly increased albuminuria and coronary artery revascularization outcomes in patients with diabetes

Relationship of mildly increased albuminuria and coronary artery revascularization outcomes in patients with diabetes

Association of Chronic Kidney Disease with Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus

Incidence of Myocardial Infarction, Stroke, and Death in Patients With Age-Related Macular Degeneration Treated With Intravitreal Anti–Vascular Endothelial Growth Factor Therapy

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