Impact of CKD Progression on Cardiovascular Disease Risk in a Contemporary UK Cohort of Individuals With Diabetes
Journal article, 2020

Introduction: It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, based on estimated glomerular filtration rate (eGFR) slope estimates and the risk for CVD. Methods: We compared the updated eGFR slope calculated over multiple overlapping 2-year periods and the updated mean eGFR. Incident CKD subjects were selected from a prevalent population with diabetes (T2DM). Subjects from the UK Clinical Practice Research Data Link GOLD (CPRD) were followed from CKD diagnosis (n = 30,222) until heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), or a composite end point including all 3 event types (MACE plus), mortality, database dropout, or end of study follow-up. Results: Both the updated eGFR slope and updated mean eGFR were associated with MACE plus and HF. Updated eGFR slope decline of > –3 ml/min/1.73 m2 increased the risk for MACE plus (adjusted hazard ratio [HR] = 1.45; 95% confidence interval [CI], 1.26–1.67), HF (HR = 1.50; 95% CI, 1.27–1.76), and MI (HR = 1.39; 95% CI, 1.01–1.91). Conclusions: This study strongly supports current evidence that CKD is an independent risk factor for CVD. From a clinical perspective, both rate of progression and cumulative status of CKD describe distinct aspects of the cardiorenal risk among persons with diabetes. This evidence is essential to enable more timely and improved use of treatments in this population.



chronic kidney disease



heart disease


C. Cabrera

Karolinska Institutet

AstraZeneca AB

Alison S. Lee

Commonwealth Informatics

Marita Olsson

AstraZeneca AB

Chalmers, Mathematical Sciences

V. Schnecke

Novo Nordisk

Klara Westman

University of Gothenburg

Marcus Lind

NU Hospital Group

University of Gothenburg

Peter J. Greasley

AstraZeneca AB

Stanko Skrtic

AstraZeneca AB

University of Gothenburg

Kidney International Reports

2468-0249 (ISSN)

Vol. 5 10 1651-1660

Subject Categories

General Practice

Urology and Nephrology

Cardiac and Cardiovascular Systems





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