METHODS: We analyzed 1173 participants with chronic kidney disease (CKD) G1 to G5 without kidney replacement therapy from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD). Participants were categorized into three groups according to the change in the CAC score between enrollment and year 4 (non-progressors, ≤0 AU; moderate progressors, 1-199 AU; and severe progressors, ≥200 AU). The primary outcome was the development of KFRT.
RESULTS: During a follow-up period of 4690 person-years (median, 4.2 years), the primary outcome occurred in 230 (19.6 %) participants. The incidence of KFRT was 37.6, 54.3, and 80.9 per 1000 person-years in the non-, moderate, and severe progressors, respectively. In the multivariable cause-specific hazard model, the hazard ratios (HRs) for the moderate and severe progressors were 1.71 (95 % confidence interval [CI], 1.02-2.87) and 2.55 (95 % CI, 1.07-6.06), respectively, compared with non-progressors. A different definition of CAC progression with a threshold of 100 AU yielded similar results in a sensitivity analysis.
CONCLUSIONS: CAC progression is associated with an increased risk of KFRT in patients with CKD. Our findings suggest that coronary atherosclerosis changes increase the risk of CKD progression.
方法:我们分析了来自KoreaN队列研究慢性肾脏病患者(KNOW-CKD)的1173例慢性肾脏病(CKD)G1至G5患者,但没有进行肾脏替代治疗。根据入学和第4年之间的CAC评分变化,参与者分为三组(非进展者,≤0AU;中等进步者,1-199AU;和严重的进步者,≥200AU)。主要结果是KFRT的发展。
结果:在4690人年的随访期间(中位数,4.2years),主要结局发生在230名(19.6%)参与者中.在非,中度,和严重的进步者,分别。在多变量特定原因的危险模型中,中度和重度进展者的风险比(HR)为1.71(95%置信区间[CI],1.02-2.87)和2.55(95%CI,1.07-6.06),分别,与非进步者相比。阈值为100AU的CAC进展的不同定义在敏感性分析中产生了相似的结果。
结论:CAC进展与CKD患者KFRT风险增加相关。我们的研究结果表明冠状动脉粥样硬化改变增加了CKD进展的风险。