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Kidney Week

Abstract: PO0523

End Point Abstraction and Incident Events in a Cohort of >5000 CKD Patients After 6.5 Years of Follow-up in the German CKD (GCKD) Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Schultheiss, Ulla T., Universitatsklinikum Freiburg Institute of Genetic Epidemiology and Renal Division, Freiburg, Baden-Württemberg, Germany
  • Kotsis, Fruzsina Kinga, Universitatsklinikum Freiburg Institute of Genetic Epidemiology and Renal Division, Freiburg, Baden-Württemberg, Germany
  • Wytopil, Monika, University Hospital Erlangen Department of Nephrology, Erlangen, Germany
  • Steinbrenner, Inga, Universitätsklinikum Freiburg Institute of Genetic Epidemiology, Freiburg, Germany
  • Stockmann, Helena, Charite University Medicine Berlin Department of Nephrology, Berlin, Germany
Background

Etiopathologies and progression of chronic kidney disease (CKD) differ among affected individuals with a differential risk to develop comorbid conditions like cardiovascular disease, adverse renal events like end-stage kidney disease (ESKD) or acute kidney injury (AKI), and early mortality. Evidence about CKD trajectories and a broad spectrum of adverse events in large cohorts of CKD patients under regular nephrological care is scarce, motivating the generation of such evidence from the ongoing GCKD study with 5217 enrolled patients.

Methods

In GCKD, endpoints are continuously abstracted from hospital discharge letters and death certificates based on a standardized endpoint catalogue (Fig. 1 legend). To reduce inter-observer variability, endpoints were abstracted by a trained physicians endpoint committee. Data from the first 6.5 years of follow-up was evaluated (data freeze 04/2020).

Results

Among all 5217 patients 2867 had at least one endpoint and 9978 endpoints occurred. At the end of the first 6.5 years, 628 patients were deceased. Cardiovascular endpoints occurred most frequently (Fig. 1) driven by arrhythmias (Nevents=713) and decompensated heart failure (Nevents=707), followed by renal events, which were driven mostly by 1176 non-dialysis dependent AKIs and 207 temporary dialysis events. 522 ESKD events occurred (457 dialysis, 65 kidney transplants). Hospitalizations due to infections were also frequent. Death occurred mainly due to cardiovascular disease (N=175) and due to infections (N=147). 26 patients died due to forgoing of dialysis.

Conclusion

Over an observation period of 6.5 years, 9979 incident endpoints occurred in a cohort of 5217 CKD patients. The highest number of endpoints occurred for cardiovascular and renal events. The high risk of recurrent events for patients in these categories underscores the need to focus on high-risk patient subgroups.

Figure 1: A) Number of patients with at least one endpoint and B) number of events

Funding

  • Government Support - Non-U.S.