Lifetime risk of stroke stratified by chronic kidney disease and hypertension in the general Asian population: the Ohasama study

Introduction: Those who are considered to be low risk in short term such as 10 year risk actually have high risk of cardiovascular disease for the remaining lifespan at younger age. Absolute risk of Lifetime risk (LTR) is more useful and understandable for lay audience compared with short term risk or relative risk. CKD (Chronic Kidney Disease) is global burden of cardiovascular disease (CVD) and hypertension is damaging complication of CKD for CVD. To date, there have been no reports of LTR with the outcome of CVD death based on CKD in Asian population. Hypothesis: We sought to estimate LTR of CVD death stratified by the status of CKD and hypertension. Methods: We used data from EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan) which is designed to pool data from nationwide and regional cohort studies in Japan. Modified Kaplan-Meier approach was used to estimate the remaining lifetime risk of cardiovascular death at each index age starting from 40 years according to CKD stratified by Hypertension. Participants were classified into four groups, which were those without CKD and hypertension (CKD-/HT-), those with CKD but without hypertension (CKD+/HT-), those without CKD but with hypertension (CKD-/HT+), and those with both CKD and hypertension (CKD+/HT+). Results: A total of 44,582 participants from 8 cohorts was included in the analysis. Mean follow-up period was 14.9 years with 662,488 person years and total CVD death was 1,035 in men and 1,160 in women. The LTRs at the index age of 40 years increased in groups with CKD and/or HT as follows: 12.6% (95% confidence interval: 9.4 - 14.5%) in CKD-/HT- group, 20.6% (11.4 - 25.9%) in CKD+/HT- group, 23.2% (19.9 - 25.2%) in CKD-/HT+ group, and 27.9% (21.7 - 32.9%) in CKD+/HT+ group for men; 11.3%(8.9 - 13.2%), 17.4%(13.2 - 20.4%) , 17.8%(15.3 - 19.8%) , and 22.7%(19.5 - 25.2%) for women. Conclusions: We observed that complication of CKD and hypertension are collectively responsible for lifetime risk due to CVD death. Management of blood pressure from an early age is important to reduce CVD mortality in CKD patients.

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Vitamin D insufficiency and deficiency with stages of chronic kidney disease in an Asian population

BMC Nephrology ◽

10.1186/1471-2369-14-206 ◽

2013 ◽

Vol 14 (1) ◽

Cited By ~ 20

Author(s):

Bancha Satirapoj ◽

Pokkrong Limwannata ◽

Amnart Chaiprasert ◽

Ouppatham Supasyndh ◽

Panbuppa Choovichian

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Asian Population ◽

Vitamin D Insufficiency

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Fibroblast Growth Factor 23 Predicts Mortality and End-Stage Renal Disease in a Canadian Asian Population with Chronic Kidney Disease

Nephron ◽

10.1159/000479300 ◽

2017 ◽

Vol 137 (3) ◽

pp. 190-196 ◽

Cited By ~ 5

Author(s):

Ishwarlal Jialal ◽

Fernando Camacho ◽

Bharat Nathoo ◽

Paul Tam ◽

Roma Pahwa ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Growth Factor ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Fibroblast Growth Factor 23 ◽

Asian Population ◽

Fibroblast Growth ◽

Stage Renal Disease ◽

End Stage

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Blood pressure and antihypertensive medication profile in a multiethnic Asian population of stable chronic kidney disease patients

Singapore Medical Journal ◽

10.11622/smedj.2016089 ◽

2016 ◽

Vol 57 (05) ◽

pp. 267-273 ◽

Cited By ~ 2

Author(s):

BW Teo ◽

HR Chua ◽

WK Wong ◽

S Haroon ◽

S Subramanian ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Antihypertensive Medication ◽

Asian Population

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Kidney function, blood pressure and proteinuria were associated with pregnancy outcomes of pregnant women with chronic kidney disease: a single-center, retrospective study in the Asian population

Clinical and Experimental Nephrology ◽

10.1007/s10157-020-01865-0 ◽

2020 ◽

Vol 24 (6) ◽

pp. 547-556 ◽

Cited By ~ 1

Author(s):

Satoshi Kumakura ◽

Koji Okamoto ◽

Saeko Takeuchi ◽

Mai Yoshida ◽

Takashi Nakamichi ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Retrospective Study ◽

Kidney Disease ◽

Pregnant Women ◽

Kidney Function ◽

Pregnancy Outcomes ◽

Asian Population ◽

Single Center

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Abstract 503: Chronic Kidney Disease is a Risk for Abdominal Aortic Aneurysm but Diabetes Mellitus is a Protective Factor in Japanese

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.503 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Hidemi Takeuchi ◽

Haruhito Uchida ◽

Michihiro Okuyama ◽

Ryoko Umebayashi ◽

Yuki Kakio ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Chronic Kidney Disease ◽

Abdominal Aortic Aneurysm ◽

Kidney Disease ◽

Aortic Aneurysm ◽

Protective Factor ◽

Multivariate Logistic Regression Analysis ◽

Asian Population ◽

Abdominal Aortic

Objective: Abdominal aortic aneurysm (AAA) is the most common aortic aneurysm. Chronic kidney disease (CKD) and diabetes mellitus (DM) are considered as risk factors for cardiovascular diseases. However, the association between CKD and AAA remains unknown. Although DM has been reported to exert protective effect on the incidence and development of AAA in western population, such protective role of DM was not explored in the Asian population. The purpose of this study was to determine the relationship of CKD and DM and the presence of AAA. We performed a cross-sectional retrospective case-control study in Asian population. Methods and Results: We enrolled 261 patients with AAA (AAA+) and age-and-sex matched 261 patients without AAA (AAA-) at two hospitals between 2008 and 2014, and examined the association between the risk factors and the presence of AAA. Furthermore, to investigate AAA prevalencein each group, we enrolled 1126 patients with CKD and 400 patients with DM. The presence of CKD in patients with AAA+ was significantly higher than that in patients with AAA- (AAA+; 65 %, AAA-; 52 %, P = 0.004). The presence of DM in patients with AAA+ was significantly lower than that in patients with AAA- (AAA+; 17 %, AAA-; 35 %, P < 0.001). A multivariate logistic regression analysis demonstrated that hypertension, ischemic heart disease and CKD were independent determinants, whereas, DM was the only independent protective factor, for the presence of AAA. The prevalence of AAA in patients with CKD 65 years old and above was 5.1 %, whereas, that in patients with DM 65 years old and above was only 0.6 %. Conclusion: CKD is a positively associated with the presence of AAA. In contrast, DM is a negatively associated with the presence of AAA.

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