Prevalence of atheromatous and non-atheromatous cardiovascular disease by age in chronic kidney disease.


Journal

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
ISSN: 1460-2385
Titre abrégé: Nephrol Dial Transplant
Pays: England
ID NLM: 8706402

Informations de publication

Date de publication:
01 05 2020
Historique:
received: 05 02 2018
accepted: 27 07 2018
pubmed: 1 9 2018
medline: 13 11 2020
entrez: 1 9 2018
Statut: ppublish

Résumé

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. 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). 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)]. 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).

Sections du résumé

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).

Identifiants

pubmed: 30169874
pii: 5086073
doi: 10.1093/ndt/gfy277
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

827-836

Informations de copyright

© The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Auteurs

Cédric Villain (C)

Service de Néphrologie-Dialyse, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France.
CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.

Marie Metzger (M)

CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.

Christian Combe (C)

Service de Néphrologie Transplantation Dialyse Aphérèses, CHU de Bordeaux, Bordeaux, France.
INSERM Unité 1026, Université de Bordeaux, Bordeaux, France.

Denis Fouque (D)

Service de Néphrologie, Centre Hospitalier Lyon Sud, Université Lyon, UCBL, Carmen, Pierre-Bénite, France.

Luc Frimat (L)

CHRU Nancy-Brabois, Vandœuvre-lès-Nancy, France.
INSERM CIC-EC CIE6 - EA 4360 Apemac, Nancy Université, Vandœuvre-lès-Nancy, France.

Christian Jacquelinet (C)

CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.
Agence de Biomédecine, La Plaine Saint-Denis, France.

Maurice Laville (M)

Service de Néphrologie, Centre Hospitalier Lyon Sud, Université Lyon, UCBL, Carmen, Pierre-Bénite, France.

Serge Briançon (S)

INSERM CIC-EC CIE6 - EA 4360 Apemac, Nancy Université, Vandœuvre-lès-Nancy, France.

Julie Klein (J)

INSERM Unité 1048, Institute of Cardiovascular and Metabolic Disease, Toulouse, France.
Université Toulouse III Paul-Sabatier, Toulouse, France.

Joost P Schanstra (JP)

INSERM Unité 1048, Institute of Cardiovascular and Metabolic Disease, Toulouse, France.
Université Toulouse III Paul-Sabatier, Toulouse, France.

Bruce M Robinson (BM)

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Nicolas Mansencal (N)

CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.
Service de Cardiologie, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France.

Bénédicte Stengel (B)

CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.

Ziad A Massy (ZA)

Service de Néphrologie-Dialyse, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France.
CESP, INSERM UMRS 1018, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.

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Classifications MeSH