Cédric Villain1,2, Marie Metzger2, Christian Combe3,4, Denis Fouque5, Luc Frimat6,7, Christian Jacquelinet2,8, Maurice Laville5, Serge Briançon7, Julie Klein9,10, Joost P Schanstra9,10, Bruce M Robinson11, Nicolas Mansencal2,12, Bénédicte Stengel2, Ziad A Massy1,2. 1. Service de Néphrologie-Dialyse, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France. 2. CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France. 3. Service de Néphrologie Transplantation Dialyse Aphérèses, CHU de Bordeaux, Bordeaux, France. 4. INSERM Unité 1026, Université de Bordeaux, Bordeaux, France. 5. Service de Néphrologie, Centre Hospitalier Lyon Sud, Université Lyon, UCBL, Carmen, Pierre-Bénite, France. 6. CHRU Nancy-Brabois, Vandœuvre-lès-Nancy, France. 7. INSERM CIC-EC CIE6 - EA 4360 Apemac, Nancy Université, Vandœuvre-lès-Nancy, France. 8. Agence de Biomédecine, La Plaine Saint-Denis, France. 9. INSERM Unité 1048, Institute of Cardiovascular and Metabolic Disease, Toulouse, France. 10. Université Toulouse III Paul-Sabatier, Toulouse, France. 11. Arbor Research Collaborative for Health, Ann Arbor, MI, USA. 12. Service de Cardiologie, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France.
Abstract
BACKGROUND: Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKD patients. METHODS: We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3-4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease). RESULTS: Mean age was 66.8 and mean Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR was 32.9 mL/min/1.73 m2. In the <65, (65-74), (75-84) and ≥85 year age groups, the prevalence was, respectively, 18.7, 35.5, 42.9 and 37.8% for atheromatous CVD, and 14.9, 28.4, 38.1 and 56.4% for non-atheromatous CVD. After adjusting for albuminuria, sex and CVD risk factors, the odds ratio (OR) [95% confidence interval (CI)] for (65-74), (75-84) and ≥85 age groups (compared with the <65 group) was, respectively, 1.99 (1.61-2.46), 2.89 (2.30-3.62), 2.72 (1.77-4.18) for atheromatous CVD and 2.07 (1.66-2.58), 3.15 (2.50-3.97), 7.04 (4.67-10.61) for non-atheromatous CVD. Compared with patients with an eGFR ≥30 mL/min/1.73 m2, those with an eGFR <30 mL/min/1.73 m2 had a higher OR for atheromatous CVD [1.21 (1.01-1.44)] and non-atheromatous CVD [1.16 (0.97-1.38)]. CONCLUSIONS: In this large cohort of CKD patients, both atheromatous and non-atheromatous CVD were highly prevalent and more frequent in older patients. In a given age group, the prevalence of atheromatous and non-atheromatous CVD was similar (except for a greater prevalence of non-atheromatous CVD after 85).
BACKGROUND: Although chronic kidney disease (CKD) and age are major risk factors for cardiovascular disease (CVD), little is known about the relative proportions of atheromatous and non-atheromatous CVD by age in CKDpatients. METHODS: We used baseline data from the French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort of 3033 patients (65% men) with CKD Stages 3-4 to study crude and adjusted associations between age, the estimated glomerular filtration rate (eGFR), atheromatous CVD (coronary artery disease, peripheral artery disease and stroke) and non-atheromatous CVD (heart failure, cardiac arrhythmia and valvular heart disease). RESULTS: Mean age was 66.8 and mean Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR was 32.9 mL/min/1.73 m2. In the <65, (65-74), (75-84) and ≥85 year age groups, the prevalence was, respectively, 18.7, 35.5, 42.9 and 37.8% for atheromatous CVD, and 14.9, 28.4, 38.1 and 56.4% for non-atheromatous CVD. After adjusting for albuminuria, sex and CVD risk factors, the odds ratio (OR) [95% confidence interval (CI)] for (65-74), (75-84) and ≥85 age groups (compared with the <65 group) was, respectively, 1.99 (1.61-2.46), 2.89 (2.30-3.62), 2.72 (1.77-4.18) for atheromatous CVD and 2.07 (1.66-2.58), 3.15 (2.50-3.97), 7.04 (4.67-10.61) for non-atheromatous CVD. Compared with patients with an eGFR ≥30 mL/min/1.73 m2, those with an eGFR <30 mL/min/1.73 m2 had a higher OR for atheromatous CVD [1.21 (1.01-1.44)] and non-atheromatous CVD [1.16 (0.97-1.38)]. CONCLUSIONS: In this large cohort of CKDpatients, both atheromatous and non-atheromatous CVD were highly prevalent and more frequent in older patients. In a given age group, the prevalence of atheromatous and non-atheromatous CVD was similar (except for a greater prevalence of non-atheromatous CVD after 85).
Authors: Cédric Villain; Sophie Liabeuf; Marie Metzger; Christian Combe; Denis Fouque; Luc Frimat; Christian Jacquelinet; Maurice Laville; Serge Briançon; Ronald L Pisoni; Nicolas Mansencal; Bénédicte Stengel; Ziad A Massy Journal: Clin Kidney J Date: 2019-06-10
Authors: Ziad A Massy; Jean Ferrières; Eric Bruckert; Céline Lange; Sophie Liabeuf; Maja Velkovski-Rouyer; Bénédicte Stengel Journal: Kidney Int Rep Date: 2019-07-30