Abstract: FR-PO344
Risk Factors for Total Stroke in Patients with CKD: The Chronic Renal Insufficiency Cohort Study
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Chen, Jing, Tulane University, New Orleans, Louisiana, United States
- Kleinpeter, Myra A., Tulane University, New Orleans, Louisiana, United States
- Zhang, Alex R., Boston University, Boston, Massachusetts, United States
- Zhao, Cong, Tulane University, New Orleans, Louisiana, United States
- Geng, Siyi, Tulane University, New Orleans, Louisiana, United States
- Alvarado, Flor, Tulane University, New Orleans, Louisiana, United States
- Alper, Arnold B., Tulane University, New Orleans, Louisiana, United States
- Bhargava, Rhea, Tulane University, New Orleans, Louisiana, United States
- Lukitsch, Ivo, Ochsner Health, New Orleans, Louisiana, United States
- Marshall, Allison N., Tulane University, New Orleans, Louisiana, United States
- Hamm, L. Lee, Tulane University, New Orleans, Louisiana, United States
- He, Jiang, Tulane University, New Orleans, Louisiana, United States
Background
The incidence of stroke is much higher in CKD patients than in the general population. In addition, CKD is associated with a worse outcome after stroke. We studied the risk factors for stroke in a cohort of CKD patients.
Methods
3,547 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study were included in this analysis after excluding 392 participants with stroke at the baseline visit. Stroke events were reported by participants and adjudicated by 2 vascular neurologists. Cox proportional hazards models with backward selection were used to investigate the association of risk factors with incident stroke. All risk factors, including traditional cardiovascular risk factors, eGFR, urine albumin, inflammatory biomarkers, mineral bone disorder biomarkers, fibrotic biomarkers, and NT-proBNP, were included in the model.
Results
The average baseline age was 57.3 years and 54.7% were women. Over a mean follow-up time of 10.7 years, 167 incident stroke events occurred. The age-adjusted incidence of total stroke was 4.4 per 1,000 person-years: 4.9 per 1,000 person-years in men, and 3.9 per 1,000 person-years in women. The significant multivariable-adjusted hazard ratios (HR) and 95% CI for stroke associated with various risk factors are presented in the Table.
Conclusion
This study indicates that age, black race, smoking, albuminuria, and mineral bone disorder are independently associated with an increased risk of stroke. Future studies are warranted to assess the benefits of specific interventions to reduce the risk of stroke in individuals with CKD.
Significant Multivariable-Adjusted Hazard Ratios of Stroke Associated with the Risk Factors
| Multivariable-adjusted | ||
| Variables | Hazard ratio (95% CI) | P-value |
| Age (per 1SD, 11 years) | 1.49 (1.19, 1.87) | 0.001 |
| Race Non-Hispanic White vs. Non-Hispanic Black | 0.62 (0.40, 0.95) | 0.04 |
| Other vs. Non-Hispanic Black | 0.58 (0.32, 1.06) | |
| Current Smoking | 1.97 (1.22, 3.19) | 0.005 |
| Log (uACR) (per 1SD, 2.31, ug/mg) | 1.48 (1.19, 1.84) | 0.0004 |
| Alkaline phosphatase (per 1SD, 34.84, u/L) | 1.22 (1.05, 1.41) | 0.01 |
| Log fibroblast growth factor 23 (per 1SD, 0.75, RU/mL) | 1.29 (1.06, 1.56) | 0.01 |
Funding
- NIDDK Support