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Abstract: TH-PO709

Race and the Risk of Heart Failure in CKD

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Hartsell, Sydney Elizabeth, The University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Ye, Xiangyang, The University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Boucher, Robert E., The University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Sarwal, Amara, The University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Wei, Guo, The University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, The University of Utah School of Medicine, Salt Lake City, Utah, United States
Background

Minority populations are disproportionately affected by poor outcomes in CKD. It is unknown whether there are racial disparities in HF incidence in CKD.

Methods

We created a national VA cohort (N = 801,572) extracted using the VA Informatics and Computing Infrastructure (VINCI) platform. We included patients with CKD stage 3A, 3B or 4 by outpatient CKD-EPI 2021 eGFR values collected 2010-2015, and excluded those with baseline HF by ICD9/10 codes. Incident HF through August 2018 were defined by ICD codes. We related race to incident HF with multivariable cox regression models, adjusting for demographics, comorbidities, and baseline BP.

Results

74.8% were white, 18.4% black and 6.8% other races. Median age was 74.2 yrs, 96.4% male, and skewed to early-stage CKD (70.7%, 23.9%, 5.4% with stages 3A, 3B, 4). HTN was slightly more common in black patients (93.1% vs 92.3% in other races vs 91.3% in whites). There were 125,965 HF events over 3.5 million patient-years of follow up. In the entire cohort, compared to whites, blacks (HR 1.02, 95% CI 1.01-1.04) and other races (HR 1.01, 95% CI 0.99-1.04) did not have appreciably higher risk of HF. However, within CKD stages, compared to whites, black veterans with CKD stage 3B and 4 had a higher hazard of HF (Figure).

Conclusion

Black patients with more advanced CKD have a higher risk of incident HF than white patients. Interventions to reduce HF risk in black patients with advanced CKD are needed.

HF by race and CKD stage

Funding

  • NIDDK Support