heart failure and chronic kidney disease

A new study examines the relative risks of heart failure, coronary heart disease, and stroke in patients with chronic kidney disease.

Cardiovascular disease is a leading cause of death in patients with chronic kidney disease. Understanding the contribution of heart failure, coronary heart disease and stroke for chronic kidney disease patients on the overall cardiovascular disease burden may lead to the development of strategies that yield better outcomes.

A new study published in the Journal of American Medical Association Cardiology examined the risk differences between heart failure, coronary heart disease, and stroke in patients with chronic kidney disease.

The authors of the study pooled participants without a history of cardiovascular disease from 3 diverse community-based cohort studies: the Jackson Heart Study (2000-2010), the Cardiovascular Health Study (1989 – 2003), and the Multi-Ethnic Study of Atherosclerosis. (2000-2012). In total there were 14 462 participants, the mean age was 63, 59% were women, and 44% were African American. Ten percent of the participants had chronic kidney disease. Chronic kidney disease was defined as estimated glomerular filtration rate less than 60 ml/min/1.73 m2 calculated using the combined creatinine-cystatin C CKD-Epidemiology Collaboration Equation.

A regression model was used to calculate the incidence rates and the risk differences for heart failure, chronic heart disease, and stroke. These were compared to participants with or without chronic kidney disease. The model adjusted for demographics, high blood pressure, high cholesterol, diabetes, and smoking.

Study results indicate that participants with chronic kidney disease were at greater risk of developing cardiovascular disease than participants without chronic kidney disease.  Among theses participants, the risk of heart failure was comparable to the risk of chronic heart disease and both risks were greater than the risk of stroke. The risk of heart failure associated with chronic kidney disease was especially large among African American and Hispanic adults.

The authors conclude that efforts to improve cardiovascular health in these patients should focus on preventing heart failure as well as preventing chronic heart disease.

Written By: Lynn Kim

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