Associations Between Kidney Histopathologic Lesions and Incident Cardiovascular Disease in Adults With Chronic Kidney Disease
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
Methodological detailsobservational, 2 academic medical centres
- Observational
- 2 academic medical centres
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
Death or MACE, by individual lesion
| HR (95% CI) | P value | ||
|---|---|---|---|
| Mesangial expansion | 2.98 (1.08–8.30) | P = 0.04 | |
| Arteriolar sclerosis | 1.68 (1.03–2.72) | P = 0.04 | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Death or MACE, by chronicity scoreSevere chronicityvs Minimal chronicityFully adjusted models | 2.50 (1.06–5.87) | P = 0.04 | |
| Death or MACE, by chronicity scoreModerate chronicityvs Minimal chronicityFully adjusted models | 1.66 (0.74–3.75) | P = 0.22 | |
| Death or MACE, by chronicity scoreMild chronicityvs Minimal chronicityFully adjusted models | 2.22 (1.01–4.89) | P = 0.047 | |
| 0.20.5125Hazard 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.
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