Kidney Week

Abstract: PO2310

The Effect of Cardiometabolic Comorbidities on Risk of CKD Incidence: A Longitudinal Cohort Study

Session Information

• CKD: Drugs, Diet, and Other Determinants
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Nichols, Gregory A., Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, United States

Gregory A. Nichols, PhD

• Kyaw, Moe H., Boehringer Ingelheim US, Ridgefield, Connecticut, United States

Moe H. Kyaw,

• Chatterjee, Satabdi, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany

Satabdi Chatterjee,

• Steubl, Dominik, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany

Dominik Steubl,

Background

Chronic kidney disease (CKD) and cardiometabolic conditions are closely inter-related. We studied the risk of incident CKD among patients who had or developed type 2 diabetes (T2D), atherosclerotic cardiovascular disease (ASCVD), or heart failure (HF).

Methods

We conducted a longitudinal cohort study using the electronic medical records of Kaiser Permanente Northwest to identify 371,109 adult patients without CKD at baseline (first known eGFR >60ml/min/1.73m² between 2005-2017) and followed them through 2019 for incident CKD (two eGFR measurements <60 3-12 months apart). We assessed T2D, ASCVD and HF at baseline and prior to CKD incidence. We used generalized estimating equation (GEE) models to calculate age/sex-adjusted CKD incidence per 1,000 person-years independently for baseline T2D, HF, and ASCVD. Time-dependent Cox regression models were used to determine the effect of baseline or development of T2D, ASCVD and HF on CKD incidence adjusting for age, sex, race/ethnicity, renin angiotensin aldosterone system (RAAS) inhibitor and statin use, smoking, and blood pressure >140/90 mmHg.

Results

Study subjects were 49.7+14.9 years old and 56% were women. CKD incidence among patients with T2D or HF was more than double vs. patients without T2D or HF, and 55% higher among patients with vs. without ASCVD (Figure). In the time-dependent model, risk of CKD incidence was increased by more than 2-fold by HF (hazard ratio 2.12, 95% CI 2.05-2.19), 71% by T2D (1.71, 1.66-1.75), and 26% by ASCVD (1.26, 1.23-1.30).

Conclusion

Cardiometabolic conditions, particularly HF and T2D are independent risk factors of incident CKD. Treating the cardiometabolic-renal syndrome as a single clinical entity may benefit these patients.

Funding

• Commercial Support – Boehringer Ingelheim