scholarly journals Chronic Kidney Disease as a Risk Factor for Cardiovascular Disease and All-Cause Mortality: A Pooled Analysis of Community-Based Studies

2004 ◽  
Vol 15 (5) ◽  
pp. 1307-1315 ◽  
Author(s):  
D. E. Weiner
2005 ◽  
Vol 16 (11) ◽  
pp. 3403-3410 ◽  
Author(s):  
Panagiotis T. Vlagopoulos ◽  
Hocine Tighiouart ◽  
Daniel E. Weiner ◽  
John Griffith ◽  
Dan Pettitt ◽  
...  

2021 ◽  
Author(s):  
Zhuoting Zhu ◽  
Xianwen Shang ◽  
Wei Wang ◽  
Jason Ha ◽  
Yifan Chen ◽  
...  

AbstractAims/hypothesisTo investigate the joint effects of retinopathy and systemic vascular comorbidities on mortality.MethodsThis study included 5703 participants (≥40 years old) from the 2005-2008 National Health and Nutrition Examination Survey. The Early Treatment Diabetic Retinopathy Study grading scale was used to evaluate the retinopathy status. Systemic vascular comorbidities included diabetes mellitus (DM), high blood pressure (HBP), chronic kidney disease (CKD) and cardiovascular disease (CVD). Time to death was calculated as the time from baseline to either the date of death or censoring (December 31st, 2015), whichever came first. Risks of mortality were estimated using Cox proportional hazards models.ResultsAfter adjusting for confounders, the presence of retinopathy predicted higher all-cause mortality (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.09-1.81). The all-cause mortality among participants with both retinopathy and systemic vascular comorbidities including DM (HR, 1.63; 95% CI, 1.06-2.50), HBP (HR, 1.46; 95% CI, 1.03-2.08), CKD (HR, 1.71; 95% CI, 1.24-2.35) and CVD (HR, 1.88; 95% CI, 1.19-2.96) was significantly higher than that among those without either condition.Conclusions/interpretationIn this prospective study, individuals with retinopathy had increased all-cause mortality. The joint effects of retinopathy and major systemic vascular comorbidities increased the all-cause mortality further, suggesting that more extensive vascular risk factor assessment and management are needed to detect the burden of vascular pathologies and improve long-term survival in individuals with retinopathy.Research in contextWhat is already known about this subject?Retinopathy has been recognized as an independent risk factor for mortality.What is the key question?What are the joint effects of retinopathy and systemic vascular comorbidities (including diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) on mortality?What are the new findings?Consistent evidence on the increased risk of mortality among individuals with retinopathy was noted in a large sample of middle-aged and older adults.The co-occurrence of retinopathy and systemic vascular conditions (diabetes mellitus, hypertension and chronic kidney disease and cardiovascular disease) further increased all-cause mortality independent of other covariates.How might this impact on clinical practice in the foreseeable future?Individuals with retinopathy may benefit from a comprehensive vascular assessment.Intensive vascular risk reduction is needed in the management of patients with retinopathy and and micro- or macrovascular disorders.Highlighted the importance of retinopathy screening using retinal imaging for identifying individuals at high risk of mortality, particularly among individuals with systemic vascular comorbidities.


ESC CardioMed ◽  
2018 ◽  
pp. 2670-2673
Author(s):  
Susanna Price

Chronic kidney disease is a global health burden, with an estimated prevalence of 11–13%, with the majority of patients diagnosed as stage 3, and is an independent risk factor for cardiovascular disease. The incidence of acute kidney injury is increasing, and estimated to be present in one in five acute hospital admissions, and there is a bidirectional relationship between acute and chronic kidney disease. The relevance to the patient with cardiovascular disease relates to increased perioperative risk, as reduced kidney function is an independent risk factor for adverse postoperative cardiovascular outcomes including myocardial infarction, stroke, and progression of heart failure. Furthermore, patients undergoing cardiovascular investigations are at risk of developing acute kidney injury, in particular where iodinated contrast is administered. This chapter reviews the classification of renal disease and its impact on cardiovascular disease, as well as potential methods for reducing the development of contrast-induced acute kidney injury.


BMJ ◽  
2019 ◽  
pp. l1580 ◽  
Author(s):  
Yan Xie ◽  
Benjamin Bowe ◽  
Yan Yan ◽  
Hong Xian ◽  
Tingting Li ◽  
...  

AbstractObjectiveTo estimate all cause mortality and cause specific mortality among patients taking proton pump inhibitors (PPIs).DesignLongitudinal observational cohort study.SettingUS Department of Veterans Affairs.ParticipantsNew users of PPIs (n=157 625) or H2 blockers (n=56 842).Main outcome measuresAll cause mortality and cause specific mortality associated with taking PPIs (values reported as number of attributable deaths per 1000 patients taking PPIs).ResultsThere were 45.20 excess deaths (95% confidence interval 28.20 to 61.40) per 1000 patients taking PPIs. Circulatory system diseases (number of attributable deaths per 1000 patients taking PPIs 17.47, 95% confidence interval 5.47 to 28.80), neoplasms (12.94, 1.24 to 24.28), infectious and parasitic diseases (4.20, 1.57 to 7.02), and genitourinary system diseases (6.25, 3.22 to 9.24) were associated with taking PPIs. There was a graded relation between cumulative duration of PPI exposure and the risk of all cause mortality and death due to circulatory system diseases, neoplasms, and genitourinary system diseases. Analyses of subcauses of death suggested that taking PPIs was associated with an excess mortality due to cardiovascular disease (15.48, 5.02 to 25.19) and chronic kidney disease (4.19, 1.56 to 6.58). Among patients without documented indication for acid suppression drugs (n=116 377), taking PPIs was associated with an excess mortality due to cardiovascular disease (22.91, 11.89 to 33.57), chronic kidney disease (4.74, 1.53 to 8.05), and upper gastrointestinal cancer (3.12, 0.91 to 5.44). Formal interaction analyses suggested that the risk of death due to these subcauses was not modified by a history of cardiovascular disease, chronic kidney disease, or upper gastrointestinal cancer. Taking PPIs was not associated with an excess burden of transportation related mortality and death due to peptic ulcer disease (as negative outcome controls).ConclusionsTaking PPIs is associated with a small excess of cause specific mortality including death due to cardiovascular disease, chronic kidney disease, and upper gastrointestinal cancer. The burden was also observed in patients without an indication for PPI use. Heightened vigilance in the use of PPI may be warranted.


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