Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses.
cardiovascular diseases
coronary disease
kidney diseases
stroke
Journal
Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763
Informations de publication
Date de publication:
15 11 2022
15 11 2022
Historique:
pubmed:
1
11
2022
medline:
18
11
2022
entrez:
31
10
2022
Statut:
ppublish
Résumé
End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke. Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank. There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values <60 or >105 mL·min In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function.
Sections du résumé
BACKGROUND
End-stage renal disease is associated with a high risk of cardiovascular events. It is unknown, however, whether mild-to-moderate kidney dysfunction is causally related to coronary heart disease (CHD) and stroke.
METHODS
Observational analyses were conducted using individual-level data from 4 population data sources (Emerging Risk Factors Collaboration, EPIC-CVD [European Prospective Investigation into Cancer and Nutrition-Cardiovascular Disease Study], Million Veteran Program, and UK Biobank), comprising 648 135 participants with no history of cardiovascular disease or diabetes at baseline, yielding 42 858 and 15 693 incident CHD and stroke events, respectively, during 6.8 million person-years of follow-up. Using a genetic risk score of 218 variants for estimated glomerular filtration rate (eGFR), we conducted Mendelian randomization analyses involving 413 718 participants (25 917 CHD and 8622 strokes) in EPIC-CVD, Million Veteran Program, and UK Biobank.
RESULTS
There were U-shaped observational associations of creatinine-based eGFR with CHD and stroke, with higher risk in participants with eGFR values <60 or >105 mL·min
CONCLUSIONS
In people without manifest cardiovascular disease or diabetes, mild-to-moderate kidney dysfunction is causally related to risk of CHD, highlighting the potential value of preventive approaches that preserve and modulate kidney function.
Identifiants
pubmed: 36314129
doi: 10.1161/CIRCULATIONAHA.122.060700
pmc: PMC9662821
doi:
Types de publication
Observational Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1507-1517Subventions
Organisme : Medical Research Council
ID : MC_UU_00017/4
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00006/1
Pays : United Kingdom
Organisme : BLRD VA
ID : I01 BX004821
Pays : United States
Organisme : Medical Research Council
ID : MC_U137686849
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RG/19/4/34452
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00011/6
Pays : United Kingdom
Organisme : CSRD VA
ID : IK2 CX001780
Pays : United States
Organisme : British Heart Foundation
ID : RG/18/13/33946
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_QA137853
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12026/6
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_17228
Pays : United Kingdom
Organisme : British Heart Foundation
ID : RG/13/13/30194
Pays : United Kingdom
Organisme : NIEHS NIH HHS
ID : P30 ES005605
Pays : United States
Organisme : British Heart Foundation
ID : RG/13/16/30528
Pays : United Kingdom
Organisme : British Heart Foundation
ID : CH/12/2/29428
Pays : United Kingdom
Investigateurs
Anna Koettgen
(A)
Jonathan Shaw
(J)
Robert Atkins
(R)
Paul Zimmet
(P)
Peter Whincup
(P)
Peter Willeit
(P)
Johann Willeit
(J)
Christoph Leitner
(C)
Edoardo Casiglia
(E)
Valérie Tikhonoff
(V)
Anne Tybjaerg-Hansen
(A)
Peter Schnohr
(P)
Shoaib Afzal
(S)
David Lora Pablos
(DL)
Cristina Martin Arriscado
(CM)
Carmen Romero Ferreiro
(CR)
Robert B Wallace
(RB)
Hannah Stocker
(H)
Ben Schöttker
(B)
Bernd Holleczek
(B)
Angela Chetrit
(A)
Lennart Welin
(L)
Kurt Svärdsudd
(K)
Lennart Welin
(L)
Kurt Svärdsudd
(K)
Lauren Lissner
(L)
Dominique Hange
(D)
Kirsten Mehlig
(K)
Dorothea Nagel
(D)
Paul E Norman
(PE)
Osvaldo Almeida
(O)
Leon Flicker
(L)
Jun Hata
(J)
Takanori Honda
(T)
Yoshihiko Furuta
(Y)
Hiroyasu Iso
(H)
Akihiko Kitamura
(A)
Isao Muraki
(I)
Jukka T Salonen
(JT)
Tomi-Pekka Tuomainen
(TP)
E M van Zutphen
(EM)
N M van Schoor
(NM)
Chiara Donfrancesco
(C)
Cinzia Lo Noce
(C)
Luigi Palmieri
(L)
Mary Cushman
(M)
Richard Kronmal
(R)
Wolfgang Koenig
(W)
Christa Meisinger
(C)
Georg Lappas
(G)
Peter M Nilsson
(PM)
Olle Melander
(O)
Bo Hedblad
(B)
Dorothea Nitsch
(D)
Jackie A Cooper
(JA)
Jonathan Shaffer
(J)
Joseph Schwartz
(J)
Daichi Shimbo
(D)
Shinichi Sato
(S)
Hiroyasu Iso
(H)
Mina Hayama-Terada
(M)
Simerjot Jassal
(S)
Thor Aspelund
(T)
Bolli Thorsson
(B)
Gunnar Sigurdsson
(G)
Layal Chaker
(L)
Kamran M Ikram
(KM)
Maryam Kavousi
(M)
Hugh Tunstall-Pedoe
(H)
Mark Woodward
(M)
Henry Völzke
(H)
Günay Can
(G)
Hüsniye Yüksel
(H)
Uğur Özkan
(U)
Hideaki Nakagawa
(H)
Yuko Morikawa
(Y)
Masao Ishizaki
(M)
Johan Ärnlöv
(J)
Volker Arndt
(V)
Edith Feskens
(E)
Johanna M Geleijnse
(JM)
Daan Kromhout
(D)
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