Ryu Hyunjin, Kim Jayoun, Kang Eunjeong, Hong Yeji, Chae Dong-Wan, Choi Kyu Hun, Han Seung Hyeok, Yoo Tae Hyun, Lee Kyubeck, Kim Yong-Soo, Chung Wookyung, Oh Yun Kyu, Kim Soo Wan, Kim Yeong Hoon, Sung Su Ah, Lee Joongyub, Park Sue K, Ahn Curie, Oh Kook-Hwan
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea.
Sci Rep. 2021 Jan 13;11(1):1131. doi: 10.1038/s41598-020-80877-y.
Few studies have investigated the incidence of cardiovascular disease (CVD) in the Asian chronic kidney disease (CKD) population. This study assessed the incidence of CVD, death, and a composite outcome of CVD and death in a prospective Korean predialysis CKD cohort. From a total of 2179 patients, incidence rates were analyzed, and competing risk analyses were conducted according to CKD stage. Additionally, incidence was compared to the general population. During a median 4.1 years of follow-up, the incidence of CVD, all-cause death, and the composite outcome was 17.2, 9.6, and 24.5 per 1000 person-years, respectively. These values were higher in diabetic vs. non-diabetic subjects (P < 0.001). For all outcomes, incidence rates increased with increasing CKD stage (CVD, P = 0.001; death, P < 0.001; and composite, P < 0.001). Additionally, CKD stage G4 [hazard ratio (HR) 2.8, P = 0.008] and G5 (HR 5.0, P < 0.001) were significant risk factors for the composite outcome compared to stage G1 after adjustment. Compared to the general population, the total cohort population (stages G1-G5) showed significantly higher risk of CVD (HR 2.4, P < 0.001) and the composite outcome (HR 1.7, P < 0.001). The results clearly demonstrate that CKD is a risk factor for CVD in an Asian population.
很少有研究调查亚洲慢性肾脏病(CKD)人群中心血管疾病(CVD)的发病率。本研究评估了韩国一个前瞻性透析前CKD队列中CVD、死亡以及CVD和死亡的复合结局的发病率。对总共2179例患者的发病率进行了分析,并根据CKD分期进行了竞争风险分析。此外,还将发病率与普通人群进行了比较。在中位4.1年的随访期间,CVD、全因死亡和复合结局的发病率分别为每1000人年17.2、9.6和24.5。糖尿病患者与非糖尿病患者的这些值更高(P<0.001)。对于所有结局,发病率均随CKD分期的增加而升高(CVD,P=0.001;死亡,P<0.001;复合结局,P<0.001)。此外,调整后,与G1期相比,CKD G4期[风险比(HR)2.8,P=0.008]和G5期(HR 5.0,P<0.001)是复合结局的显著危险因素。与普通人群相比,整个队列人群(G1-G5期)的CVD风险(HR 2.4,P<0.001)和复合结局风险(HR 1.7,P<0.001)显著更高。结果清楚地表明,CKD是亚洲人群CVD的一个危险因素。