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Abstract: SA-PO523

Association of CKD and Cardiovascular Disease Risk with All-Cause Mortality: A Mediation Analysis in Chinese Adults

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Author

  • Li, Yang, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China
Background

To evaluate the complex relationship of chronic kidney disease (CKD) and cardiovascular disease (CVD) risk with mortality in different age groups and the mediation effect of CVD risk among Chinese adults.

Methods

A total of 7533 participants from the China Health and Nutrition Survey (CHNS) cohort were included in this study. CKD was defined as eGFR <60 mL/min/1.73m2. Framingham risk score (FRS) was used to assess CVD risk. The interaction, joint association of CVD risk and CKD on mortality, and subsequent mediation effect were evaluated using multivariable Cox regression.

Results

CHNS cohort recorded 266 deaths over a mean follow-up time of 5.04 years. The all-mortality rates among adults with CKD and high CVD risk were significantly higher than healthy controls (22.48 and 21.30 per 1000 person-years). The adjusted hazard ratios (aHR) were 1.70 (95% CI 1.27-2.28) and 1.62 (95%CI 1.26-2.09), respectively. There was a negative interaction between CKD and CVD risk on mortality. The association between CKD and mortality was stronger in low+medium CVD risk group (aHR=1.87, 95% CI 1.20-2 .91). Besides, mortality hazard was highest in CKD patients with high CVD risk (aHR=3.14, 95% CI 1.92-5.14). Mediation analysis showed that CVD risk mediated 33.4% of the effect of CKD on all-cause mortality (p<0.001). After adjusting for the moderator of age, the mediation proportion was 7.2%-10.3%.

Conclusion

Comprehensive strategies including lifestyle modifications, diet restrictions, and cardio-nephrology multidisciplinary treatment for mitigating CVD risk in CKD patients should focus on middle-aged people and early disease detection.

Funding

  • Government Support – Non-U.S.