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Kidney Week

Abstract: SA-PO1178

Kidney Failure and Mortality Outcomes in Patients with Combined CKD and Heart Failure: The CaRe Study

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, United States
  • Greene, Stephen, Division of Cardiology, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, United States
  • Adamsson Eryd, Samuel, Cardiovascular, Renal and Metabolism Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
  • Bodegard, Johan, RWE Research, Oslo, Norway
  • Mullin, Katrina, Cardiovascular, Renal and Metabolism Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
  • Thuresson, Marcus, Statisticon AB, Uppsala, Sweden
  • Kondo, Toru, Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Savarese, Gianluigi, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
Background

We aimed to describe characteristics and kidney outcomes in patients with CKD, HF or comorbid CKD+HF in the CaRe study.

Methods

Adults with CKD, HF, or CKD+HF on 1 Jan 2022 (index) were identified from Japan (Medical Data Vision), Sweden (nationwide administrative registries) and the USA (Optum’s de-identified Clinformatics® Data Mart). Endpoints (identified via diagnosis/surgical codes) included time to first event for end-stage kidney disease (ESKD; ICD-10 N18.5), dialysis, kidney transplant, their composite (severe kidney complications), all-cause death and renal death (Sweden) in the year after index. Between-group differences were estimated by age/sex-adjusted Cox regression.

Results

We identified 615 356 patients from Japan, 236 991 from Sweden and 1 055 022 from the USA (Table). In the three countries, respectively, risks of severe kidney complications in those with CKD+HF were 1.7-, 1.7- and 3.4-fold higher vs CKD only and 9.2-, 11.6- and 4.8-fold higher vs HF only. Risks of ESKD and dialysis were also higher in those with CKD+HF vs CKD or HF only (Figure). All-cause death was higher in those with CKD+HF (Japan, 7%; Sweden, 22%; USA, 17%) vs CKD only (3%; 9%; 6%) and HF only (3%; 11%; 11%). In Sweden, renal death was higher in those with CKD+HF (1.6%) vs CKD only (0.5%) and HF only (0.2%).

Conclusion

Patients with comorbid CKD+HF have greater risks of kidney outcomes and death vs CKD or HF alone, emphasizing the importance of integrated cardiorenal management in these high-risk patients.

Funding

  • Commercial Support – AstraZeneca

Digital Object Identifier (DOI)