scholarly journals Letter by Tsuda Regarding Article, “Proteinuria, but Not eGFR, Predicts Stroke Risk in Chronic Kidney Disease: Chronic Renal Insufficiency Cohort Study”

Stroke ◽  
2015 ◽  
Vol 46 (11) ◽  
Author(s):  
Kazushi Tsuda
2015 ◽  
Vol 115 (9) ◽  
pp. 1281-1286 ◽  
Author(s):  
Marie A. Guerraty ◽  
Boyang Chai ◽  
Jesse Y. Hsu ◽  
Akinlolu O. Ojo ◽  
Yanlin Gao ◽  
...  

2020 ◽  
Vol 120 (7) ◽  
pp. 1151-1162.e3 ◽  
Author(s):  
Jessica M. Madrigal ◽  
Esteban Cedillo-Couvert ◽  
Ana C. Ricardo ◽  
Lawrence J. Appel ◽  
Cheryl A.M. Anderson ◽  
...  

2012 ◽  
Vol 33 (6) ◽  
pp. 1238-1244 ◽  
Author(s):  
Claudia M. Lora ◽  
Ana C. Ricardo ◽  
Carolyn S. Brecklin ◽  
Michael J. Fischer ◽  
Robert T. Rosman ◽  
...  

Author(s):  
Kirsten S Dorans ◽  
Hua He ◽  
Jing Chen ◽  
Mirela Dobre ◽  
Alan S Go ◽  
...  

Abstract Background Patients with chronic kidney disease (CKD) have an increased risk of peripheral arterial disease (PAD). The ankle–brachial index (ABI), a noninvasive measure of PAD, is a predictor of adverse events among individuals with CKD. In general populations, changes in ABI have been associated with mortality, but this association is not well understood among patients with CKD. Methods We conducted a prospective study of 2920 participants in the Chronic Renal Insufficiency Cohort Study without lower extremity revascularization or amputation at baseline and with at least one follow-up ABI measurement (taken at annual visits) during the first 4 years of follow-up. The ABI was obtained by the standard protocol. Results In Cox proportional hazard regression analyses, we found a U-shaped association of average annual change in ABI with all-cause mortality. After adjusting for baseline ABI and other covariates, compared with participants with an average annual change in ABI of 0–<0.02, individuals with an average annual change in ABI <−0.04 or ≥0.04 had multivariable-adjusted hazard ratios (HRs) of 1.81 [95% confidence interval (CI) 1.34–2.44) and 1.42 (95% CI 1.12–1.82) for all-cause mortality, respectively. Compared with the cumulative average ABI of 1.0–<1.4, multivariable-adjusted HRs for those with a cumulative average ABI of <0.9, 0.9–<1.0 and ≥1.4 were 1.93 (95% CI 1.42–2.61), 1.20 (0.90–1.62) and 1.31 (0.94–1.82), respectively. Conclusions This study indicates both larger decreases and increases in average annual changes in ABI (>0.04/year) were associated with higher mortality risk. Monitoring changes in ABI over time may facilitate risk stratification for mortality among individuals with CKD.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Katherine T Mills ◽  
Jing Chen ◽  
Wei Yang ◽  
Lawrence Appel ◽  
John Kusek ◽  
...  

Introduction: Chronic kidney disease (CKD) patients are at an increased risk of cardiovascular disease (CVD) compared to the general population. Prior studies have produced contradictory results for the associations of sodium and potassium intake with the risk of CVD. In addition, these associations have not been investigated in patients with CKD. Hypothesis: We assessed the prospective associations between urinary sodium and potassium excretion and CVD event rates among patients with CKD. Methods: The Chronic Renal Insufficiency Cohort Study (CRIC) is a prospective cohort study of 3,939 participants with CKD from seven locations in the United States. Dietary sodium and potassium intake are assessed by averaging three 24-hour urinary measures and calibrating to sex-specific mean 24-hour urinary creatinine excretion. Composite CVD event is defined as myocardial infarction (MI), stroke, or congestive heart failure (CHF). CVD events are reported every six months and confirmed by medical record adjudication. Results: Over an average 6.5 years of follow-up, 660 CVD events were observed. The highest quartile (>197.7 mmol/24 hours) of adjusted sodium excretion had a hazard ratio (HR) of 1.52 (95% confidence interval 1.23, 1.88; p for trend across quartiles 70.5 mmol/24 hours) of adjusted potassium excretion had a HR of 1.46 (1.14, 1.87; p for trend across quartiles 0.0009) for composite CVD events compared to the lowest quartile (≤41.2 mmol/24 hours). When modeled continuously, every 100-mmol/24 hours higher adjusted sodium excretion was associated with an increased HR of 1.25 (1.14, 1.36) for composite CVD events, 1.25 (1.13, 1.39) for CHF, 1.32 (1.08, 1.61) for stroke, and 1.09 (0.93, 1.27) for MI. In addition, every 50-mmol/24 hour higher adjusted potassium intake was associated with an increased HR of 1.25 (1.10, 1.41) for composite CVD events, 1.32 (1.15, 1.52) for CHF, 1.11 (0.81, 1.54) for stroke, and 1.00 (0.79, 1.27) for MI. Conclusions: Our study found that high dietary sodium and potassium are both associated with an increased risk of CVD among patients with CKD. These findings suggest that reductions in high dietary sodium and potassium intake might reduce the risk of CVD among patients with CKD.


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