Kidney Week

Abstract: PUB046

Disease Progression Pathways and Characteristics of Chinese Patients with Comorbid Heart Failure and CKD: The CaRe Study

Session Information

• Publication Only

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Zhao, Minghui, Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China

Minghui Zhao, PhD

• Liu, Tong, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China

Tong Liu, MD

• Zhang, Luxia, Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China

Luxia Zhang, MD, MPH

• Wang, Jinwei, Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China

Jinwei Wang, PhD

• Zhao, Jinhua, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China

Jinhua Zhao, MD

• Adamsson Eryd, Samuel, Cardiovascular, Renal and Metabolism Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden

Samuel Adamsson Eryd, PhD

• Mullin, Katrina, Cardiovascular, Renal and Metabolism Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom

Katrina Mullin, PhD

• Zhao, Wenyan, Medical Affairs, AstraZeneca Investment China Co, Shanghai, China

Wenyan Zhao, MS

• Zou, Liangqiang, Medical Affairs, AstraZeneca Investment China Co, Shanghai, China

Liangqiang Zou, MD, PhD

Background

Heart failure (HF) and chronic kidney disease (CKD) form a mutually amplifying pathophysiological loop that worsens prognosis. In China, where 82 million adults have CKD and 14.3 million have HF, the clinical trajectory of their intersection remains unmapped. While multinational studies have begun to address this gap, China-specific real-world evidence is absent. The CaRe study is a multinational observational study designed to delineate disease onset sequence, clinical characteristics, and guideline-directed medical therapy (GDMT) utilization in patients with comorbid HF and CKD. This analysis presents the first Chinese cohort data on comorbid HF and CKD patients.

Methods

This retrospective cohort study, indexed on September 1, 2022, utilized electronic health records from Tianjin Healthcare and Medical Big Data Platform, to identify adults (≥18 years) diagnosed with HF or CKD. Eligible patients had an established diagnosis of HF or CKD at the index date and at least one subsequent clinical visit. HF was defined by a recorded diagnosis code, while CKD was defined by a diagnosis code, two eGFR measurements <60 mL/min/1.73 m² or two positive proteinuria tests at least 90 days apart. The primary outcomes were the prevalence of comorbid HF and CKD in the general adult population and the proportion of patients categorized by disease presentation sequence (HF-to-CKD, CKD-to-HF, or simultaneous diagnosis). Secondary outcomes included clinical characteristics and GDMT utilization across the different patient groups (comorbid CKD and HF vs. HF-only and CKD-only patients).

Results

From January 2018 to September 2022, 7,606,704 patients were enrolled in general adult population. Full data analysis will be completed by mid-May 2026 and results of the primary and secondary outcomes will be presented at ASN KIDNEY WEEK 2026.

Conclusion

This is the first Chinese cohort data on comorbid HF and CKD. Our findings delineate disease progression pathways and clinical characteristics of this high-risk group, while identifying unmet medical needs and practice gaps in GDMT utilization, offering insights to guide optimized patient management strategies.

Funding

• Commercial Support – AstraZeneca China