Cargando…

Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study

BACKGROUND: Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study. METHODS AND RESULTS: Kidney function was assessed by estimated glomerular filtration rate (e...

Descripción completa

Detalles Bibliográficos
Autores principales: He, Jiang, Shlipak, Michael, Anderson, Amanda, Roy, Jason A., Feldman, Harold I., Kallem, Radhakrishna Reddy, Kanthety, Radhika, Kusek, John W., Ojo, Akinlolu, Rahman, Mahboob, Ricardo, Ana C., Soliman, Elsayed Z., Wolf, Myles, Zhang, Xiaoming, Raj, Dominic, Hamm, Lee, Appel, Lawrence J., Go, Alan S., Lash, James P., Townsend, Raymond R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524087/
https://www.ncbi.nlm.nih.gov/pubmed/28515118
http://dx.doi.org/10.1161/JAHA.116.005336
_version_ 1783252417665564672
author He, Jiang
Shlipak, Michael
Anderson, Amanda
Roy, Jason A.
Feldman, Harold I.
Kallem, Radhakrishna Reddy
Kanthety, Radhika
Kusek, John W.
Ojo, Akinlolu
Rahman, Mahboob
Ricardo, Ana C.
Soliman, Elsayed Z.
Wolf, Myles
Zhang, Xiaoming
Raj, Dominic
Hamm, Lee
Appel, Lawrence J.
Go, Alan S.
Lash, James P.
Townsend, Raymond R.
author_facet He, Jiang
Shlipak, Michael
Anderson, Amanda
Roy, Jason A.
Feldman, Harold I.
Kallem, Radhakrishna Reddy
Kanthety, Radhika
Kusek, John W.
Ojo, Akinlolu
Rahman, Mahboob
Ricardo, Ana C.
Soliman, Elsayed Z.
Wolf, Myles
Zhang, Xiaoming
Raj, Dominic
Hamm, Lee
Appel, Lawrence J.
Go, Alan S.
Lash, James P.
Townsend, Raymond R.
author_sort He, Jiang
collection PubMed
description BACKGROUND: Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study. METHODS AND RESULTS: Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin C‐based‐eGFR was 2.43 (2.10, 2.80), and 1 SD higher log‐albuminuria was 1.65 (1.53, 1.78), all P<0.001. When all 3 kidney function measures were simultaneously included in the model, lower cystatin C‐based eGFR and higher log‐albuminuria remained significantly and directly associated with incidence of heart failure. After adjusting for eGFR, albuminuria, and other traditional cardiovascular risk factors, anemia (1.37, 95% CI 1.09, 1.72, P=0.006), insulin resistance (1.16, 95% CI 1.04, 1.28, P=0.006), hemoglobin A1c (1.27, 95% CI 1.14, 1.41, P<0.001), interleukin‐6 (1.15, 95% CI 1.05, 1.25, P=0.002), and tumor necrosis factor‐α (1.10, 95% CI 1.00, 1.21, P=0.05) were all significantly and directly associated with incidence of heart failure. CONCLUSIONS: Our study indicates that cystatin C‐based eGFR and albuminuria are better predictors for risk of heart failure compared to creatinine‐based eGFR. Furthermore, anemia, insulin resistance, inflammation, and poor glycemic control are independent risk factors for the development of heart failure among patients with chronic kidney disease.
format Online
Article
Text
id pubmed-5524087
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-55240872017-08-02 Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study He, Jiang Shlipak, Michael Anderson, Amanda Roy, Jason A. Feldman, Harold I. Kallem, Radhakrishna Reddy Kanthety, Radhika Kusek, John W. Ojo, Akinlolu Rahman, Mahboob Ricardo, Ana C. Soliman, Elsayed Z. Wolf, Myles Zhang, Xiaoming Raj, Dominic Hamm, Lee Appel, Lawrence J. Go, Alan S. Lash, James P. Townsend, Raymond R. J Am Heart Assoc Original Research BACKGROUND: Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study. METHODS AND RESULTS: Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin C‐based‐eGFR was 2.43 (2.10, 2.80), and 1 SD higher log‐albuminuria was 1.65 (1.53, 1.78), all P<0.001. When all 3 kidney function measures were simultaneously included in the model, lower cystatin C‐based eGFR and higher log‐albuminuria remained significantly and directly associated with incidence of heart failure. After adjusting for eGFR, albuminuria, and other traditional cardiovascular risk factors, anemia (1.37, 95% CI 1.09, 1.72, P=0.006), insulin resistance (1.16, 95% CI 1.04, 1.28, P=0.006), hemoglobin A1c (1.27, 95% CI 1.14, 1.41, P<0.001), interleukin‐6 (1.15, 95% CI 1.05, 1.25, P=0.002), and tumor necrosis factor‐α (1.10, 95% CI 1.00, 1.21, P=0.05) were all significantly and directly associated with incidence of heart failure. CONCLUSIONS: Our study indicates that cystatin C‐based eGFR and albuminuria are better predictors for risk of heart failure compared to creatinine‐based eGFR. Furthermore, anemia, insulin resistance, inflammation, and poor glycemic control are independent risk factors for the development of heart failure among patients with chronic kidney disease. John Wiley and Sons Inc. 2017-05-17 /pmc/articles/PMC5524087/ /pubmed/28515118 http://dx.doi.org/10.1161/JAHA.116.005336 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
He, Jiang
Shlipak, Michael
Anderson, Amanda
Roy, Jason A.
Feldman, Harold I.
Kallem, Radhakrishna Reddy
Kanthety, Radhika
Kusek, John W.
Ojo, Akinlolu
Rahman, Mahboob
Ricardo, Ana C.
Soliman, Elsayed Z.
Wolf, Myles
Zhang, Xiaoming
Raj, Dominic
Hamm, Lee
Appel, Lawrence J.
Go, Alan S.
Lash, James P.
Townsend, Raymond R.
Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title_full Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title_fullStr Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title_full_unstemmed Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title_short Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
title_sort risk factors for heart failure in patients with chronic kidney disease: the cric (chronic renal insufficiency cohort) study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524087/
https://www.ncbi.nlm.nih.gov/pubmed/28515118
http://dx.doi.org/10.1161/JAHA.116.005336
work_keys_str_mv AT hejiang riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT shlipakmichael riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT andersonamanda riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT royjasona riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT feldmanharoldi riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT kallemradhakrishnareddy riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT kanthetyradhika riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT kusekjohnw riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT ojoakinlolu riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT rahmanmahboob riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT ricardoanac riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT solimanelsayedz riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT wolfmyles riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT zhangxiaoming riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT rajdominic riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT hammlee riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT appellawrencej riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT goalans riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT lashjamesp riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy
AT townsendraymondr riskfactorsforheartfailureinpatientswithchronickidneydiseasethecricchronicrenalinsufficiencycohortstudy