J Korean Med Sci.  2017 Feb;32(2):231-239. 10.3346/jkms.2017.32.2.231.

Baseline Cardiovascular Characteristics of Adult Patients with Chronic Kidney Disease from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

• Kim H
• Yoo TH
• Choi KH
• Oh KH
• Lee J
• Kim SW
• Kim TH
• Sung S
• Han SH
• KNOW-CKD Group

• KMID: 2364166
• DOI: http://doi.org/10.3346/jkms.2017.32.2.231

Abstract

Cardiovascular disease (CVD) is the most common cause of death in patients with chronic kidney disease (CKD). We report the baseline cardiovascular characteristics of 2,238 participants by using the data of the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) study. The cohort comprises 5 subcohorts according to the cause of CKD: glomerulonephritis (GN), diabetic nephropathy (DN), hypertensive nephropathy (HTN), polycystic kidney disease (PKD), and unclassified. The average estimated glomerular filtration rate (eGFR) was 50.5 ± 30.3 mL/min⁻¹/1.73 m⁻² and lowest in the DN subcohort. The overall prevalence of previous CVD was 14.4% in all patients, and was highest in the DN followed by that in the HTN subcohort. The DN subcohort had more adverse cardiovascular risk profiles (higher systolic blood pressure [SBP], and higher levels of cardiac troponin T, left ventricular mass index [LVMI], coronary calcium score, and brachial-ankle pulse wave velocity [baPWV]) than the other subcohorts. The HTN subcohort exhibited less severe cardiovascular risk profiles than the DN subcohort, but had more severe cardiovascular risk features than the GN and PKD subcohorts. All these cardiovascular risk profiles were inversely correlated with eGFR. In conclusion, this study shows that the KNOW-CKD cohort exhibits high cardiovascular burden, as other CKD cohorts in previous studies. Among the subcohorts, the DN subcohort had the highest risk for CVD. The ongoing long-term follow-up study up to 10 years will further delineate cardiovascular characteristics and outcomes of each subcohort exposed to different risk profiles.

Keyword

Cardiovascular Disease; Chronic Kidney Disease; KNOW-CKD; Diabetes; Hypertension; Polycystic Kidney Disease; Glomerulonephritis; Epidemiology

MeSH Terms

Adult*
Blood Pressure
Calcium
Cardiovascular Diseases
Cause of Death
Cohort Studies*
Diabetic Nephropathies
Epidemiology
Follow-Up Studies
Glomerular Filtration Rate
Glomerulonephritis
Humans
Hypertension
Polycystic Kidney Diseases
Prevalence
Pulse Wave Analysis
Renal Insufficiency, Chronic*
Troponin T
Calcium
Troponin T

Figure

• 

  Fig. 1 baPWV of the participants. (A) baPWV according to the etiology of CKD. (B) baPWV according to the CKD stages. baPWV = brachial-ankle pulse wave velocity, CKD = chronic kidney disease, GN = glomerulonephritis, DN = diabetic nephropathy, HTN = hypertensive nephropathy, PKD = polycystic kidney disease.

• 

  Fig. 2 Categories of CAC score in the participants. (A) CAC according to the etiology of CKD. (B) CAC according to CKD stages. CAC = coronary arterial calcium, CKD = chronic kidney disease, GN = glomerulonephritis, DN = diabetic nephropathy, HTN = hypertensive nephropathy, PKD = polycystic kidney disease.

• 

  Fig. 3 LVMI of the participants. (A) LVMI according to the etiology of CKD. (B) LVMI according to CKD stages. LVMI = left ventricular mass index, CKD = chronic kidney disease, GN = glomerulonephritis, DN = diabetic nephropathy, HTN = hypertensive nephropathy, PKD = polycystic kidney disease.

• 

  Fig. 4 LV geometry of the participants. (A) LV geometry according to the etiology of CKD. (B) LV geometry according to CKD stages. LV = Left ventricular, CKD = chronic kidney disease, GN = glomerulonephritis, DN = diabetic nephropathy, HTN = hypertensive nephropathy, PKD = polycystic kidney disease.

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