Subclinical atheromatous disease detection improves cardiovascular event prediction in chronic kidney disease with and without diabetes

2018 ◽  
Author(s):  
Ana Palanca ◽  
Esmeralda Castelblanco ◽  
Angels Betriu ◽  
Jose M Valdivielso ◽  
Hector Perpinan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Event ◽  
Disease Detection ◽  
Event Prediction

scholarly journals P382Factors related to cardiovascular event after two years of follow-up of stage 3 chronic kidney disease patient's

2018 ◽  
Vol 114 (suppl_1) ◽  
pp. S97-S97
Author(s):  
Y Rivero Viera ◽  
N Esparza Martin ◽  
S Suria Gonzalez ◽  
E Bosch Benitez-Parodi ◽  
R Guerra Rodriguez ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Event

scholarly journals P0782PROGNOSTIC IMPACT OF NECK CIRCUMFERENCE ON CARDIVASCULAR OUTCOMES AND MORTALITY IN PATIENTS WITH MODERATE CHRONIC KIDNEY DISEASE: AN ANALYSIS FROM THE GERMAN CHRONIC KIDNEY DISEASE (GCKD) STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vladimir Cejka ◽  
Stefan Störk ◽  
Jennifer Nadal ◽  
Ulla T Schultheiß ◽  
Anna Köttgen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Event ◽  
Univariate Analysis ◽  
Neck Circumference ◽  
Upper Body ◽  
Event Risk ◽  
Caucasian Origin ◽  
Moderate Chronic Kidney Disease

Abstract Background and Aims Neck circumference (NC) is an approximator of upper body subcutaneous fat tissue and a marker of obesity. It has been shown to be associated with cardiovascular risk factors and incident chronic kidney disease (CKD). In CKD patients, the impact on cardiovascular events and all cause death has not been fully elucidated yet. The prognostic impact on these outcomes in a representative cohort of adult patients with moderate CKD of Caucasian origin was investigated here. Method We used data from the GCKD study, a German multi-centric prospective observational cohort study of 5217 adults with moderate chronic kidney disease, defined as eGFR 30–60 mL/min/1.73 m2 or eGFR >60 mL/min/1.73 m2 and significant proteinuria (albuminuria >300 mg/g creatinine or proteinuria >500 mg/g creatinine). Exclusion criteria were active malignancy, heart failure NYHA class IV, organ transplantation, and non-Caucasian origin. NC was measured repeatedly (annually, except at first year of follow-up) during the study, therefore, the mean value was analyzed. We report data from the 4-year follow-up visit regarding 1) a combined endpoint of non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, and peripheral artery disease event (amputation or revascularization) and 2) all-cause death as another endpoint. Cox proportional hazard regression was used to calculate hazard ratios (HR) with 95% CIs. In univariate analysis, ordinal regression with quintiles of NC was applied. Results NC was accrued in 4453 participants and analyzed. NC overall was 40±5 cm (43±4 cm in men and 37±4 cm in women, p<0.001), mean age 60±12 years, 41% were female, 96% had hypertension, 35% were diabetic, 58% had ever smoked, eGFR was 50±18 ml/min/1.73 m (CKD-EPI), BMI 28±6 kg/m, LDL-cholesterol 119±43 mg/dl. Higher quintiles of NC were associated increased risk of the cardiovascular outcome in univariate analysis: highest (44 cm) vs. lowest (36.5 cm), HR 2.34 (1.63–3.36; p<0.001). In multivariable analysis adjusted for age, sex, and BMI, this effect was reduced but still apparent: HR 1.04 (1.01–1.08, p=0.025). Age (HR per year 1.05, 1.04–1.07, p<0.001), and female sex (HR 0.69, 0.50–0.95, p=0.023), showed also significant effects, whereas BMI did not (p=0.831). The effect of higher quintiles of NC on the risk of all-cause death in univariate analysis was even stronger: highest vs. lowest, HR 3.2 (1.72–5.81, p=0.006). However, after adjustment this effect was abolished: HR 0.99 (0.95–1.04; p=0.85). Only age (HR 1.07, 1.04–1.09, p<0.001), and female sex (HR 0.45, 0.27-0.74, p=0.002), remained significant predictors of all-cause death in this model. Conclusion In patients with chronic kidney disease, we found higher NC to be associated with increased cardiovascular event risk, but not all-cause death, after adjustment for age, sex and BMI. The risk of cardiovascular outcomes and overall mortality was consistently lower in women. Our analysis supports evidence, that upper body subcutaneous adipose tissue might be an independent contributor to cardiovascular event risk.

Adipose expression of miR-130b and miR-17-5p with wasting, cardiovascular event and mortality in advanced chronic kidney disease patients

2021 ◽  
Author(s):  
Gordon Chun-Kau Chan ◽  
Win Hlaing Than ◽  
Bonnie Ching-Ha Kwan ◽  
Ka-Bik Lai ◽  
Ronald Cheong-Kin Chan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Cardiovascular Event ◽  
Cardiovascular Events ◽  
Major Adverse Cardiovascular Events ◽  
Peritoneal Dialysis Catheter ◽  
Advanced Chronic Kidney Disease ◽  
Technique Survival

Abstract Background There were limited data on the association of adipose microRNA expression with body composition and adverse clinical outcomes in patients with advanced chronic kidney disease (CKD). We aimed to evaluate the association of adipose miR-130b and miR-17–5p expressions with body composition, functional state, cardiovascular outcome and mortality in incident dialysis patients. Methods We performed a single-centre prospective cohort study. Patients who were planned for peritoneal dialysis were recruited. MiR-130b and miR-17–5p expressions were measured from subcutaneous and pre-peritoneal fat tissue obtained during peritoneal dialysis catheter insertion. Body composition and physical function were assessed by bioimpedance spectroscopy and Clinical Frailty Scale. Primary outcome was 2-year survival. Secondary outcomes were 2-year technique survival and major adverse cardiovascular event (MACE) rate. Results Adipose expression of miR-130b and miR-17–5p correlated with parameters of muscle mass including intracellular water (miR-130b: r = 0.191, P = 0.02; miR-17–5p: r = 0.211, P = 0.013) and lean tissue mass (miR-130b: r = 0.180, P = 0.03; miR-17–5p: r = 0.176, P = 0.004). miR-130b expression predicted frailty significantly (P = 0.016). Adipose miR-17–5p expression predicted 2-year all-cause survival (P = 0.020) and technique survival (P = 0.036), while miR-130b expression predicted incidence of major adverse cardiovascular events (P = 0.015). Conclusions Adipose miR-130b and miR-17–5p expressions correlated with body composition parameters, frailty, and predicted cardiovascular events and mortality in advanced CKD patients.

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