Heart failure & cardiomyopathiesCohort study
Identification and Outcomes of KDIGO-Defined Chronic Kidney Disease in 1.4 Million U.S. Veterans with Heart Failure
- Retrospective cohort study
Authors' conclusion
HF patients with KDIGO-defined CKD had higher risks for poor outcomes, most of which was not explained by abnormal kidney structure or function.
Study context
- Population
- US Veterans with heart failure (HF) not receiving kidney replacement therapy828,744 with ≥2 creatinine >90 days apart
- Participants
- 1,419,729 veterans
- Exposure
- KDIGO-defined chronic kidney disease (CKD) vs normal kidney function
- Normal kidney function (NKF)n = 365,963reference
- Estimated glomerular filtration rate (eGFR) 45-59n = 72,606
- eGFR 30-44n = 74,812
- eGFR 15-29n = 32,077
- eGFR <15n = 6,326
- Albuminurian = 32,730
- Outcome
- All-cause mortality
- Follow-up
- 5 years
Main finding
As reported in the abstract
5-year all-cause mortality
Each group vs NKFHazard ratio (95% CI)
eGFR 45-59
1.63(1.62–1.65)
eGFR 30-44
2.00(1.98–2.02)
eGFR 15-29
2.49(2.45–2.52)
eGFR <15
2.28(2.21–2.35)
Albuminuria
1.22(1.20–1.24)
- Age-adjusted HRs (95% CIs) vs NKF, eGFR 45-59, 30-44, 15-29, <15 and albuminuria respectively
- 1.13 (1.12-1.14), 1.36 (1.34-1.37), 1.87 (1.84-1.89), 2.24 (2.18-2.31) and 1.19 (1.17-1.21)
- Multivariable-adjusted HRs (95% CIs) vs NKF, same order
- 1.11 (1.10-1.12), 1.24 (1.22-1.25), 1.46 (1.43-1.48), 1.42 (1.38-1.47), and 1.13 (1.11-1.16)
Observational data: associations, not effects.
Further findings
Hospitalizations
- Similar patterns observed for associations with hospitalizations
Original publication
Identification and Outcomes of KDIGO-Defined Chronic Kidney Disease in 1.4 Million U.S. Veterans with Heart Failure. Eur J Heart Fail. Published 3 May 2024. doi:10.1002/ejhf.3210
Summarised from the published abstract; every number is checked against it