1. Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population.
- Author
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Lim CC, Teo BW, Ong PG, Cheung CY, Lim SC, Chow KY, Meng CC, Lee J, Tai ES, Wong TY, and Sabanayagam C
- Subjects
- Adult, Aged, Aged, 80 and over, Albuminuria ethnology, Biomarkers urine, Cardiovascular Diseases diagnosis, Cardiovascular Diseases mortality, Cause of Death, China ethnology, Creatinine urine, Cross-Sectional Studies, Early Diagnosis, Female, Glomerular Filtration Rate, Humans, India ethnology, Kidney physiopathology, Malaysia ethnology, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, Registries, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic physiopathology, Risk Assessment, Risk Factors, Singapore epidemiology, Time Factors, Asian People, Cardiovascular Diseases ethnology, Renal Insufficiency, Chronic ethnology
- Abstract
Background: Few studies have examined the impact of chronic kidney disease (CKD) on adverse cardiovascular outcomes and deaths in Asian populations. We evaluated the associations of CKD with cardiovascular disease (CVD) and all-cause mortality in a multi-ethnic Asian population., Design: Prospective cohort study of 7098 individuals who participated in two independent population-based studies involving Malay adults (n = 3148) and a multi-ethnic cohort of Chinese, Malay and Indian adults (n = 3950)., Methods: CKD was assessed from CKD-EPI estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). Incident CVD (myocardial infarction, stroke and CVD mortality) and all-cause mortality were identified by linkage with national disease/death registries., Results: Over a median follow-up of 4.3 years, 4.6% developed CVD and 6.1% died. Risks of both CVD and all-cause mortality increased with decreasing eGFR and increasing albuminuria (all p-trend <0.05). Adjusted hazard ratios (HR (95% confidence interval)) of CVD and all-cause mortality were: 1.54 (1.05-2.27) and 2.21 (1.67-2.92) comparing eGFR <45 vs ≥60; 2.81 (1.49-5.29) and 2.34 (1.28-4.28) comparing UACR ≥300 vs <30. The association between eGFR <60 and all-cause mortality was stronger among those with diabetes (p-interaction = 0.02). PAR of incident CVD was greater among those with UACR ≥300 (12.9%) and that of all-cause mortality greater among those with eGFR <45 (16.5%)., Conclusions: In multi-ethnic Asian adults, lower eGFR and higher albuminuria were independently associated with incident CVD and all-cause mortality. These findings extend previously reported similar associations in Western populations to Asians and emphasize the need for early detection of CKD and intervention to prevent adverse outcomes., (© The European Society of Cardiology 2014.)
- Published
- 2015
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