Kidney Week

Abstract: FR-PO199

The Association of Blood Urea Nitrogen to Creatinine Ratio with Renal and Cardiovascular Outcomes in CKD: The CRIC Study

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Saab, Georges, MetroHealth Medical Center, Cleveland, Ohio, United States

Georges Saab,

• Horwitz, Edward J., MetroHealth Medical Center, Cleveland, Ohio, United States

Edward J. Horwitz,

• Yang, Wei, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Wei Yang,

• Chen, Jing, Tulane School of Medicine, New Orleans, Louisiana, United States

Jing Chen,

• He, Jiang, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States

Jiang He,

• Ricardo, Ana C., University of Illinois at Chicago, Chicago, Illinois, United States

Ana C. Ricardo,

• Sondheimer, James H., Wayne State University School of Medicine, Detroit, Michigan, United States

James H. Sondheimer,

• Sukul, Nidhi, University of Michigan, Ann Arbor, Michigan, United States

Nidhi Sukul,

• Zhang, Xiaoming, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States

Xiaoming Zhang,

• Rahman, Mahboob, Case Western Reserve University, Cleveland, Ohio, United States

Mahboob Rahman,

• Navaneethan, Sankar D., Baylor College of Medicine, Sugar Land, Texas, United States

Sankar D. Navaneethan,

Background

Above a traditional cutoff point of 20, a blood urea nitrogen to creatinine ratio (BUN/Cr) has been suggested to be a marker of neurohormonal activation (NHA) which could contribute to progressive chronic kidney disease (CKD), cardiovascular disease (CVD) and higher mortality. We therefore examined the association of baseline BUN/Cr with these outcomes among persons with CKD.

Methods

²

We examined 3908 adult participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. Cox regression was used to examine BUN/Cr as a categorical predictor (< 20, 20-<25, 35-<30, and >=30) and a continuous predictor using splines. Outcomes included time to end-stage renal disease (ESRD), congestive heart failure (CHF), atherosclerotic events (stroke, myocardial infarction, and peripheral artery disease), atrial fibrillation, and all-cause mortality. Cox models were adjusted demographics, clinical and laboratory characteristics.

Results

Among the 3908 participants included in the analysis, mean age and eGFR was 57.7 (11.0) years and 44.9 (16.9) ml/min/1.73m2 respectively. Participants were 41.6% white and 45.2% female. Higher BUN/Cr was associated with increased risk of CHF, atherosclerotic events, atrial fibrillation, and overall mortality, but not with ESRD when examined as a continuous (Figure 1) or categorical predictor (Table 1)

Conclusion

Higher BUN/Cr is associated with an increased CVD risk and mortality but not ESRD among persons with CKD.

Table 1

Figure 1

Funding

• NIDDK Support