Sung Keun Park1, Min-Ho Kim2, Eunhee Ha3, Ju Young Jung1, Chang-Mo Oh4, Joong-Myung Choi4, Hee Yong Kang5, Yong-Sung Choi6, Min Gi Kim7, Jung-Wook Kim8, Jae-Hong Ryoo9. 1. Total healthcare center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of medicine. 2. Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital. 3. Department of Occupational and Environment Medicine, College of Medicine, Ewha Womans University. 4. Department of Preventive Medicine, School of Medicine, Kyung Hee University. 5. Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital. 6. Department of Pediatrics, School of Medicine, Kyung Hee University. 7. Department of Occupational and Environmental Medicine, Dankook University College of Medicine. 8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University School of Medicine. 9. Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University.
Abstract
AIM: Chronic kidney disease, evaluated by the estimated glomerular filtration rate (eGFR), is an established risk factor for cardiovascular disease. However, the association between renal function stratified by the eGFR and the risk of incident ischemic heart disease (IHD) in a community-based Asian population is still inconclusive. STUDY DESIGN: Retrospective longitudinal observational study. METHOD: In data from 206,919 Korean patients registered in the National Health Insurance Corporation (NHIC), we analyzed the risk of incident IHD according to the quartiles (Q) of eGFR (ml/min/1.73 m2) (Q1 ＜71.07, Q2: 71.07-83.16, Q3: 83.17-95.49, Q4 ＞95.50). The identification of IHD was based on the International Classification of Diseases (ICD) for IHD (ICD code: I20-I25) registered in the NHIC. The Cox proportional hazards model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for IHD according to quartile groups of eGFR levels. RESULTS: Q1 had the more unfavorable baseline metabolic conditions than the other quartile groups. Considering Q4 as the reference, the unadjusted HRs (95% CIs) for IHD increased significantly in the order of Q3 (1.42 [1.29-1.56]), Q2 (1.51 [1.38-1.67]), and Q1 (2.11 [1.93-2.30]), and fully adjusted HRs (95% CIs) increased significantly from Q2 (1.15 [1.04-1.27]) to Q1 (1.31 [1.18-1.44]). CONCLUSION: The risk of IHD increased significantly from individuals with an eGFR ≤ 83.16. Mildly decreased renal function is a potential risk factor for IHD.
AIM: Chronic kidney disease, evaluated by the estimated glomerular filtration rate (eGFR), is an established risk factor for cardiovascular disease. However, the association between renal function stratified by the eGFR and the risk of incident ischemic heart disease (IHD) in a community-based Asian population is still inconclusive. STUDY DESIGN: Retrospective longitudinal observational study. METHOD: In data from 206,919 Korean patients registered in the National Health Insurance Corporation (NHIC), we analyzed the risk of incident IHD according to the quartiles (Q) of eGFR (ml/min/1.73 m2) (Q1 ＜71.07, Q2: 71.07-83.16, Q3: 83.17-95.49, Q4 ＞95.50). The identification of IHD was based on the International Classification of Diseases (ICD) for IHD (ICD code: I20-I25) registered in the NHIC. The Cox proportional hazards model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for IHD according to quartile groups of eGFR levels. RESULTS: Q1 had the more unfavorable baseline metabolic conditions than the other quartile groups. Considering Q4 as the reference, the unadjusted HRs (95% CIs) for IHD increased significantly in the order of Q3 (1.42 [1.29-1.56]), Q2 (1.51 [1.38-1.67]), and Q1 (2.11 [1.93-2.30]), and fully adjusted HRs (95% CIs) increased significantly from Q2 (1.15 [1.04-1.27]) to Q1 (1.31 [1.18-1.44]). CONCLUSION: The risk of IHD increased significantly from individuals with an eGFR ≤ 83.16. Mildly decreased renal function is a potential risk factor for IHD.
Entities:
Keywords:
Estimated glomerular filtration rate; Ischemic heart disease; Renal function
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