Carlos Escobar1, Unai Aranda2, Beatriz Palacios2, Margarita Capel3, Antoni Sicras4, Aram Sicras4, Antonio Hormigo5, Roberto Alcázar6, Nicolás Manito7, Manuel Botana8. 1. Cardiology department, University hospital La Paz, Madrid, Spain. Electronic address: escobar_cervantes_carlos@hotmail.com. 2. Medical Department, AstraZeneca Farmaceutica, Madrid, Spain. 3. Pricing & Health Economics and Outcomes Research, AstraZeneca Farmaceutica, Madrid, Spain. 4. Health Economics and Outcomes Research, Atrys Health, Barcelona, Spain. 5. Primary care center San Andres-Torcal, Malaga, Spain. 6. Nephrology department, University hospital Infanta Leonor, Madrid, Spain. 7. Department of Heart Failure and Transplant, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. 8. Endocrine department, University Hospital Lucus Augusti, Lugo, Spain.
Abstract
OBJECTIVES: To describe the epidemiology, clinical profile, treatments, and to determine cardiovascular and renal outcomes after two years of follow-up in a contemporary chronic kidneay disease (CKD) population in Spain. This was also analyzed among the DAPA-CKD-like population (patients who met most inclusion criteria of DAPA-CKD trial). METHODS: Observational, retrospective, population-based study using BIG-PAC database. The CKD population was defined as patients ≥18 years, with at least one diagnostic code of CKD prior to the index date (January 1st, 2018). CKD was defined as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2 (CKD-EPI), or albuminuria >30mg/g. RESULTS: We identified 56,435 CKD patients after exclusions (76.4 years, 52.2% men, urine albumin-to-creatinine ratio 390.8mg/g, eGFR 49.7mL/min/1.73m2). CKD prevalence was 4.91% and incidence 2.10 per 1000 patient-years. Regarding treatments, 69.2% were taking renin-angiotensin system inhibitors (only 4.2% at maximal doses) and 3.5% of diabetic patients SGLT-2 inhibitors. During the two years of follow-up, rates of heart failure, all-cause death, myocardial infarction, stroke, and CKD were 17.9, 12.1, 7.2, 6.3, and 5.9 events per 100 patient-years, respectively. During this period, 44% of patients were hospitalized, and 6.8% died during hospitalization. Cardiovascular outcomes were more common in the DAPA-CKD-like population. CONCLUSIONS: In Spain, CKD population is older and comorbidities, including diabetes and heart failure, are common. Cardiovascular and renal outcomes are frequent. There is room for improvement in CKD management, particularly through the use of drugs with proven cardiovascular and renal benefit.
OBJECTIVES: To describe the epidemiology, clinical profile, treatments, and to determine cardiovascular and renal outcomes after two years of follow-up in a contemporary chronic kidneay disease (CKD) population in Spain. This was also analyzed among the DAPA-CKD-like population (patients who met most inclusion criteria of DAPA-CKD trial). METHODS: Observational, retrospective, population-based study using BIG-PAC database. The CKD population was defined as patients ≥18 years, with at least one diagnostic code of CKD prior to the index date (January 1st, 2018). CKD was defined as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2 (CKD-EPI), or albuminuria >30mg/g. RESULTS: We identified 56,435 CKD patients after exclusions (76.4 years, 52.2% men, urine albumin-to-creatinine ratio 390.8mg/g, eGFR 49.7mL/min/1.73m2). CKD prevalence was 4.91% and incidence 2.10 per 1000 patient-years. Regarding treatments, 69.2% were taking renin-angiotensin system inhibitors (only 4.2% at maximal doses) and 3.5% of diabeticpatientsSGLT-2 inhibitors. During the two years of follow-up, rates of heart failure, all-cause death, myocardial infarction, stroke, and CKD were 17.9, 12.1, 7.2, 6.3, and 5.9 events per 100 patient-years, respectively. During this period, 44% of patients were hospitalized, and 6.8% died during hospitalization. Cardiovascular outcomes were more common in the DAPA-CKD-like population. CONCLUSIONS: In Spain, CKD population is older and comorbidities, including diabetes and heart failure, are common. Cardiovascular and renal outcomes are frequent. There is room for improvement in CKD management, particularly through the use of drugs with proven cardiovascular and renal benefit.
Authors: Nicholas A Maksimowski; Xuewen Song; Eun Hui Bae; Heather Reich; Rohan John; York Pei; James W Scholey Journal: Int J Mol Sci Date: 2021-09-01 Impact factor: 5.923
Authors: Johan Sundström; Johan Bodegard; Andreas Bollmann; Marc G Vervloet; Patrick B Mark; Avraham Karasik; Tiago Taveira-Gomes; Manuel Botana; Kåre I Birkeland; Marcus Thuresson; Levy Jäger; Manish M Sood; Gijs VanPottelbergh; Navdeep Tangri Journal: Lancet Reg Health Eur Date: 2022-06-30