Urea levels and cardiovascular disease in patients with chronic kidney disease - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2022

Urea levels and cardiovascular disease in patients with chronic kidney disease

Christian Combe

Résumé

ABSTRACT Background Elevated serum urea levels are common in moderate-to-advanced chronic kidney disease (CKD). Several studies have shown that urea is a direct and indirect uraemic toxin, especially with regard to cardiovascular disease. We sought to determine whether serum urea levels are associated with adverse cardiovascular events and death before renal replacement therapy (RRT) in patients with CKD. Methods CKD-REIN is a prospective cohort of CKD nephrology outpatients not receiving maintenance dialysis. The 2507 patients included in the analysis were divided into three groups according to the baseline serum urea level (T1 <10.5, T2 10.5–15.1 and T3 ≥15.1 mmol/L). Cox proportional hazard models were used to estimate hazard ratios (HRs) for first atheromatous or non-atheromatous cardiovascular (CV) events and all-cause mortality before RRT. The models were adjusted for baseline comorbidities, laboratory data and medications. Findings Of the 2507 included patients {median [interquartile range (IQR)] age: 69 [61–77]; mean (standard deviation) estimated glomerular filtration rate (eGFR) 33.5 (11.6) mL/min/1.73 m²}, 54% had a history of cardiovascular disease. After multiple adjustments for CV risk factors (including eGFR), patients in T3 had a higher risk of atheromatous and non-atheromatous CV events than patient in T1 (n events = 451, HR [95% CI]: 1.93 [1.39; 2.69]). The adjusted HRs for death before RRT (n events = 407) were 1.31 [0.97; 1.76] and 1.73 [1.22; 2.45] for patients T2 and those in T3, respectively. Interpretation Our data suggested that urea is a predictor of CV outcomes beyond CV risk factors including eGFR.
Fichier principal
Vignette du fichier
Laville et al. Urea levels and CVD in patients with CKD.pdf (1.76 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03717300 , version 1 (08-07-2022)

Identifiants

Citer

Solène M Laville, Aymeric Couturier, Oriane Lambert, Marie Metzger, Nicolas Mansencal, et al.. Urea levels and cardiovascular disease in patients with chronic kidney disease. Nephrology Dialysis Transplantation, 2022, 38 (1), pp.184-192. ⟨10.1093/ndt/gfac045⟩. ⟨hal-03717300⟩
103 Consultations
41 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More