Cohort study
Associations Between Kidney Histopathologic Lesions and Incident Cardiovascular Disease in Adults With Chronic Kidney Disease
- Prospective cohort study
- observational
- 2 academic medical centres
Authors' conclusion
In this study, specific kidney histopathological findings were associated with increased risks of CVD events.
Study context
- Population
- Adults with CKD without history of MI, stroke or HF, Boston Kidney Biopsy Cohort, 2006–2018
- Participants
- 597 adults
- Exposure
- Kidney histopathologic lesions, chronicity score and clinicopathologic diagnostic categories
- Outcome
- Composite of:
- Death
- Incident MACE (MI, stroke, HF hospitalization)
- Follow-up
- Median 5.5 years
Main finding
As reported in the abstract
Death or incident MACE, by clinicopathologic diagnosis
Each group vs proliferative glomerulonephritisHazard ratio (95% CI)P value
Nonproliferative glomerulopathy
2.61(1.30–5.22)
P = 0.002Diabetic nephropathy
3.56(1.62–7.83)
P = 0.002Kidney vascular diseases
2.86(1.51–5.41)
P = 0.001- Death or incident major adverse cardiovascular events (MACE), overall
- 126 participants (37 per 1000 person-years)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Death or MACE, by individual lesion — Mesangial expansion vs Proliferative glomerulonephritis | 2.98 (1.08–8.30) | P = 0.04 | |
| Death or MACE, by individual lesion — Arteriolar sclerosis vs Proliferative glomerulonephritis | 1.68 (1.03–2.72) | P = 0.04 | |
| Death or MACE, by chronicity score — Severe chronicity vs Minimal chronicity · fully adjusted models | 2.50 (1.06–5.87) | P = 0.04 | |
| Death or MACE, by chronicity score — Moderate chronicity vs Minimal chronicity · fully adjusted models | 1.66 (0.74–3.75) | P = 0.22 | |
| Death or MACE, by chronicity score — Mild chronicity vs Minimal chronicity · fully adjusted models | 2.22 (1.01–4.89) | P = 0.047 | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Associations Between Kidney Histopathologic Lesions and Incident Cardiovascular Disease in Adults With Chronic Kidney Disease. JAMA Cardiol. Published 1 April 2023. doi:10.1001/jamacardio.2023.0056
Summarised from the published abstract; every number is checked against it