Characteristics, Mortality and Cardiovascular Events in Chronic Kidney Disease According To Previous Type 2 Diabetes Mellitus and/or Hypertension. A Population-Based Epidemiological Study (KIDNEES)

Introduction and objectives. Chronic Kidney Disease (CKD) entails a considerable burden of adverse outcomes. Identifying the cause is recommended but data on its prognostic value are scarce. We aimed to estimate how the clinical, cardiovascular events (CVE) and all-cause mortality (ACM) of CKD patients differs according to previous Type 2 Diabetes Mellitus (2TD) and/or Hypertension (HTN). Methods. We conducted a retrospective cohort study based on electronic health records of subjects aged 18–90 years old, with incident CKD between 1st January 2007 and 31st December 2017. The association between CKD groups according to previous T2D and/or HTN, and risk of ACM and CVE at follow-up were determined with Cox and Fine-Gray regressions, respectively. Results. 398,477 subjects were included. Median age was 74years, 55.2% were women. Individuals were distributed to HTN-CKD (51.9%), T2D-CKD (3.87%), HTN/T2D-CKD (31.4%) and unspecified-CKD (12.9%). In the multivariate analysis, with the T2D-CKD group as reference, the ACM Hazard Ratio (HR) was 0.645 (95%CI 0.624–0.667) in HTN-CKD, 0.704 (95%CI 0.682–0.728) in HTN/T2D-CKD and 0.875 (95%CI 0.844–0.908) in Unspecified-CKD group. The respective sub distribution HRs for CVE were 1.006 (CI95% 0.946–1.069), 1.238 (CI95% 1.164–1.316) and 0.722 (CI95% 0.665–0.785). Conclusion. In individuals with CKD, the risk of ACM and CVE differed according to previous HTN or/and T2D. These characteristics can help identifying individuals at higher risk of adverse outcomes, and improving the management of CKD patients in primary care.