Abstract: TH-PO1235
Strong Independent Association of CKD Progression with Cardiovascular (CV) Events in Patients with Moderate-to-Advanced CKD: Results of the PEAK-CKD Study
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Massy, Ziad, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France
- Alencar de Pinho, Natalia, Paris-Saclay University (UPS) and Versailles Saint-Quentin-en-Yvelines University (UVSQ), Villejuif, France
- Tardu, Jean, Boehringer Ingelheim France, Paris, France
- Mestdagh, Nathalie, Boehringer Ingelheim France, Paris, France
- Chollet, Julien, Boehringer Ingelheim France, Paris, France
- Laville, Maurice, University of Lyon, Lyon, France
- Girerd, Nicolas, Nancy Hospital, University of Lorraine, Nancy, France
Background
The relationship between CKD progression and CV events is poorly characterized. The aim of the study was to analyze the potential association of estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) slopes with CV events in patients with CKD stage 3 or 4.
Methods
Patients were recruited from 2013 to 2016 in the French CKD-REIN cohort. The primary endpoint was the association of eGFR and uACR slopes with CV events (composite outcome including death, hospitalizations for coronary disease or heart failure, stroke, peripheral artery disease, and/or dysrhythmias). The results were based on Bayesian frailty joint models and expressed as hazards ratios (HR) with 95% credibility intervals (CredInt). Time-to-event models were adjusted to age, sex, diabetes, systolic blood pressure, blood tests, history of CV disease, and antihypertensive therapy.
Results
Among 2724 patients (66% of men, mean age 67 years) with CDK stage 3 (58%) or 4 (42%), 44% had diabetes, and 53% had a CV history. At baseline, mean eGFR was 42 (stage 3) and 23 (stage 4) ml/min/1.73m2; median uACR was 130 mg/g with 28% (stage 3) and 50% (stage 4) above 300 mg/g. Over a median follow-up of 4.9 years (IQR 3.7 – 5.1), 38,927 and 23,072 measurements of eGFR and uACR, respectively, were made. CV events occurred in 547 patients. Current eGFR value (HR per 10%-decrease 1.04, 95% CredInt 1.01-1.07) and 1-year slope (HR per 10%-increase 1.23, 95% CredInt 1.13-1.33) were associated with higher risks of CV events. Increased uACR values (with 10 mg/g as a reference) displayed a non-linear relationship with higher risks of CV events, which was not observed after adjustment for longitudinal eGFR. No association of current uACR slope with CV events was found. These results were consistent across sensitivity analyses.
Conclusion
This well-phenotyped large CKD cohort showed that eGFR decrease is strongly associated with CV risks, independently of current eGFR and uACR levels, common risk factors, and CV history. This finding supports the relevance of actively preventing CKD progression at any CKD stage by appropriate therapies. A possible relationship between the risk of CV and uACR kinetics at earlier stages of CKD remains to be explored.
Acknowledgment
The authors meet criteria for authorship recommended by the International Committee of Medical Journal editors and supported by Good Publication Practice (GPP) guidelines. The authors did not receive payment related to the development of the abstract. Boehringer Ingelheim was given the opportunity to review the abstract for medical and scientific accuracy as well as intellectual property considerations. The study was supported and funded by Boehringer Ingelheim.
Funding
- Commercial Support – Boehringer Ingelheim