Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea
Background Certain pharmacotherapies have shown to be effective for both cardiac and kidney outcomes. Although risk prediction is important in treatment decision-making, few studies have evaluated prediction models for composite cardiovascular and kidney outcomes. Methods This study included 2,195,3...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2022-09-01
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| Series: | Kidney Research and Clinical Practice |
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| Online Access: | http://www.krcp-ksn.org/upload/pdf/j-krcp-22-005.pdf |
| _version_ | 1811216169039822848 |
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| author | Hae Hyuk Jung |
| author_facet | Hae Hyuk Jung |
| author_sort | Hae Hyuk Jung |
| collection | DOAJ |
| description | Background Certain pharmacotherapies have shown to be effective for both cardiac and kidney outcomes. Although risk prediction is important in treatment decision-making, few studies have evaluated prediction models for composite cardiovascular and kidney outcomes. Methods This study included 2,195,341 Korean adults from a nationwide cohort for chronic kidney disease and a representative sample of the general population, with a 9-year follow-up. This study evaluated prediction models for a composite of major cardiovascular events or kidney disease progression that included albuminuria and estimated glomerular filtration rate (eGFR) and/or traditional cardiovascular disease predictors. Results The addition of albuminuria and eGFR to a model for the composite outcome that included age, sex, and traditional predictors increased a C statistic by 0.0459, while the addition of traditional predictors to age, sex, albuminuria, and eGFR increased a C statistic by 0.0157. When age and sex-adjusted incidence rates were calculated across the combined Pooled-Cohort-Equations (PCEs) and Kidney Disease: Improving Global Outcomes (KDIGO) risk categories in diabetic or hypertensive participants, the incidence of ≥10 per 1,000 person-years was observed among all categories with high or very high KDIGO risk and among categories with moderate (or low) KDIGO risk and a PCEs 10-year risk of ≥10% (or ≥20%), accounting for 36% of diabetic and 18% of hypertensive populations. Conclusion This study strongly supports the utility of the KDIGO risk matrix combined with a conventional cardiovascular risk score for the prediction of composite cardiovascular and kidney outcome and provides epidemiologic data relevant to the development of efficient treatment strategies. |
| first_indexed | 2024-04-12T06:34:40Z |
| format | Article |
| id | doaj.art-7cd4e59067374b3b9cf69f0b81104a11 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-04-12T06:34:40Z |
| publishDate | 2022-09-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-7cd4e59067374b3b9cf69f0b81104a112022-12-22T03:43:55ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402022-09-0141556757910.23876/j.krcp.22.0056144Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in KoreaHae Hyuk Jung0 Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of KoreaBackground Certain pharmacotherapies have shown to be effective for both cardiac and kidney outcomes. Although risk prediction is important in treatment decision-making, few studies have evaluated prediction models for composite cardiovascular and kidney outcomes. Methods This study included 2,195,341 Korean adults from a nationwide cohort for chronic kidney disease and a representative sample of the general population, with a 9-year follow-up. This study evaluated prediction models for a composite of major cardiovascular events or kidney disease progression that included albuminuria and estimated glomerular filtration rate (eGFR) and/or traditional cardiovascular disease predictors. Results The addition of albuminuria and eGFR to a model for the composite outcome that included age, sex, and traditional predictors increased a C statistic by 0.0459, while the addition of traditional predictors to age, sex, albuminuria, and eGFR increased a C statistic by 0.0157. When age and sex-adjusted incidence rates were calculated across the combined Pooled-Cohort-Equations (PCEs) and Kidney Disease: Improving Global Outcomes (KDIGO) risk categories in diabetic or hypertensive participants, the incidence of ≥10 per 1,000 person-years was observed among all categories with high or very high KDIGO risk and among categories with moderate (or low) KDIGO risk and a PCEs 10-year risk of ≥10% (or ≥20%), accounting for 36% of diabetic and 18% of hypertensive populations. Conclusion This study strongly supports the utility of the KDIGO risk matrix combined with a conventional cardiovascular risk score for the prediction of composite cardiovascular and kidney outcome and provides epidemiologic data relevant to the development of efficient treatment strategies.http://www.krcp-ksn.org/upload/pdf/j-krcp-22-005.pdfalbuminuriacardiovascular diseasesglomerular filtration ratekidney diseasesprimary prevention |
| spellingShingle | Hae Hyuk Jung Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea Kidney Research and Clinical Practice albuminuria cardiovascular diseases glomerular filtration rate kidney diseases primary prevention |
| title | Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea |
| title_full | Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea |
| title_fullStr | Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea |
| title_full_unstemmed | Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea |
| title_short | Albuminuria, estimated glomerular filtration rate, and traditional predictors for composite cardiovascular and kidney outcome: a population-based cohort study in Korea |
| title_sort | albuminuria estimated glomerular filtration rate and traditional predictors for composite cardiovascular and kidney outcome a population based cohort study in korea |
| topic | albuminuria cardiovascular diseases glomerular filtration rate kidney diseases primary prevention |
| url | http://www.krcp-ksn.org/upload/pdf/j-krcp-22-005.pdf |
| work_keys_str_mv | AT haehyukjung albuminuriaestimatedglomerularfiltrationrateandtraditionalpredictorsforcompositecardiovascularandkidneyoutcomeapopulationbasedcohortstudyinkorea |