title: The risk for chronic kidney disease in patients with heart diseases: a 7-year follow-up in a cohort study in Taiwan.
abstract: BACKGROUND
  The worldwide increasing trend of chronic kidney disease (CKD) is of great concern and the role of heart disease deserves longitudinal studies. This study investigated the risk of developing CKD among patients with heart diseases.
  
  
  METHODS
  From universal insurance claims data in Taiwan, we retrospectively identified a cohort of 26005 patients with newly diagnosed heart diseases and 52010 people without such disease from the 2000-2001 claims. We observed prospectively both cohorts until the end of 2007 to measure CKD incidence rates in both cohorts and hazard ratios (HR) of CKD.
  
  
  RESULTS
  The incidence of CKD in the cohort with heart disease was 4.1 times greater than that in the comparison cohort (39.5 vs. 9.65 per 10,000 person-years). However, the HR changed into 2.37 (95% confidence interval (CI)=2.05-2.74) in the multivariate Cox proportional hazard model after controlling for sociodemographic characteristics and comorbidity. Compared with individuals aged<40 years, the HRs for CKD ranged from 2.70 to 4.99 in older age groups. Significant estimated relative risks of CKD observed in our patients were also independently associated with hypertension (HR=2.26, 95% CI=1.94-2.63) and diabetes mellitus (HR=2.44, 95% CI=2.13-2.80), but not with hyperlipidemia (HR=1.13, 95% CI=0.99-1.30).
  
  
  CONCLUSIONS
  This population study provides evidence that patients with heart disease are at an elevated risk of developing CKD. Hypertension and diabetes mellitus are also comorbidity associated with increasing the CKD risk independently.
authors.affiliation: Division of Nephrology and Kidney Institute, Department of Internal Medicine, China University Hospital, and Department of Public Health, China Medical University, 2 Yuh-Der Road, Taichung City, 404, Taiwan. fssung1008@yahoo.com
authors.forename: Jiung-Hsiun
authors.initials: JH
authors.lastname: Liu
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Hsu
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology