Chronic kidney disease, all-cause mortality and cardiovascular mortality among Chinese patients with established cardiovascular disease.
OBJECTIVE
This study was conducted to investigate the role of chronic kidney disease (CKD) in 1-year all cause mortality and cardiovascular mortality among Chinese patients who were at least 50 years old and had a history of coronary artery disease (CAD), stroke, or peripheral vascular disease (PAD), or with two or more cardiovascular risks.


METHODS
Of 3,732 hospitalized patients enrolled, 3,423 patients (91.7%) with complete data were eligible for 1-year follow-up. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m(2).


RESULTS
1,166 (34.1%) were diagnosed with CKD. Most cases were unrecognized. Patients having an eGFR of <30 mL/min/1.73 m(2) were less likely to be prescribed beta-blockers, statins, or aspirin (all p<0.001). A powerful relationship was observed between the severity of renal dysfunction and all causes of death or cardiovascular death. Adjusted for other covariates, the hazard ratio (HR) for all causes of death and for cardiovascular death among patients with an eGFR of 30-45 mL/min/1.73 m(2) was 1.70 (95% CI, 1.18-2.45) and 1.85 (95% CI, 1.12-3.01) as compared with 2.93 (95% CI, 1.96-4.38) and 3.47 (95% CI, 1.91-6.31) for patients with an eGFR of <30 mL/min/1.73 m(2).


CONCLUSIONS
One third of Chinese patients at high risk for atherosclerotic events were diagnosed with CKD. Most of these cases were unrecognized and undertreated. An eGFR of <45 mL/min/1.73 m(2) was an independent predictor of all causes of death and of cardiovascular death.
Yang
Jin-gang
JG
Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. jingangyang@126.com
Li
Jue
J
Lu
Changlin
C
Hasimu
Buaijiaer
B
Yang
Yuejin
Y
Hu
Dayi
D
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality*; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000401:mortality*; D015996:Survival Rate