Kidney Week

Abstract: TH-PO625

Association Between Homocysteinemia and Mortality in CKD: A Propensity-Score Matched Analysis Using NHANES-National Death Index

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Bae, Jinsuk, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea (the Republic of)

Jinsuk Bae,

• Song, Jehun, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea (the Republic of)

Jehun Song,

• Huh, Hyuk, Inje University Busan Paik Hospital, Busan, Korea (the Republic of)

Hyuk Huh,

• Bae, Eunjin, Gyeongsang National University Graduate School of Medicine, Jinju, Gyeongsangnam-do, Korea (the Republic of)

Eunjin Bae,

• Lee, Jeonghwan, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Korea (the Republic of)

Jeonghwan Lee,

• Lee, Jung Pyo, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Korea (the Republic of)

Jung Pyo Lee,

• Lee, Jong Soo, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea (the Republic of)

Jong Soo Lee,

• Yoo, Kyung Don, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea (the Republic of)

Kyung Don Yoo,

Background

Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular disease (CVD) including chronic kidney disease (CKD). In this study, we investigated the association between serum homocysteine (Hcy) level and mortality according to the presence of CKD.

Methods

Our study included data of 9,895 participants from the 1999–2016 National Health and Nutrition Examination Surveys (NHANES). Multivariable-adjusted Cox proportional hazards models using propensity-score were used to examine dose-response associations between Hcy level and mortality.

Results

Of 9,895 participants, 1032 (21.2%) participants were diagnosed with CKD. In a multivariate Cox regression analysis including all participants, Hcy level was associated with all-cause mortality, compared with the 1^st quartile in the fully adjusted model (2^nd quartile: hazard ratio (HR) 1.751, 95% confidence interval (CI) 1.348-2.274, p<0.001; 3^rd quartile: HR 2.220, 95% CI 1.726-2.855, p<0.001; 4^th quartile: HR 3.776, 95% CI 2.952-4.830, p<0.001). In the non-CKD group, there was a significant association with all-cause mortality; however, this finding was not observed in the CKD group. The observed pattern was similar after propensity score matching. In the non-CKD group, overall mortality increased in proportion to Hcy concentration (2^nd quartile: HR 2.195, 95% CI 1.299-3.709, p = 0.003; 3^rd quartile: HR 2.607, 95% CI 1.570-4.332, p<0.001; 4^th quartile: HR 3.720, 95% CI 2.254-6.139, p<0.001). However, the risk of all-cause mortality according to the quartile of Hcy level did not increase in the CKD group.

Conclusion

This study found a correlation between the Hcy level and mortality rate only in the non-CKD group. These altered risk factor patterns may be attributed to protein-energy wasting or chronic inflammation status that is accompanied by CKD.