Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts: the BiomarCaRE project
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| Title: | Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts: the BiomarCaRE project |
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| Authors: | Susana Sans, Hugh Tunstall-Pedoe, Christoph Waldeyer, Licia Iacoviello, Allan Linneberg, Martin Rehm, Kari Kuulasmaa, Wolfgang Koenig, Tarja Palosaari, Teresa Padró, Veikko Salomaa, Jill J. F. Belch, Amy Jayne McKnight, Stefan Söderberg, Dietrich Rothenbacher, Pekka Jousilahti, Simona Costanzo, Frank Kee, Tanja Zeller, Stefan Blankenberg, Johan Hultdin, Christa Meisinger, Barbara Thorand |
| Source: | BMC Med BMC Medicine r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau Institut dInvestigació Biomèdica Sant Pau (IIB Sant Pau) r-IIB SANT PAU: Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname BMC Medicine, Vol 18, Iss 1, Pp 1-13 (2020) BiomarCaRE consortium 2020, 'Contribution of cystatin C-and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts: the BiomarCaRE project', BMC Medicine, vol. 18, no. 1, 300. https://doi.org/10.1186/s12916-020-01776-7 Rothenbacher, D, Rehm, M, Iacoviello, L, Costanzo, S, Tunstall-Pedoe, H, Belch, J J F, Söderberg, S, Hultdin, J, Salomaa, V, Jousilahti, P, Linneberg, A, Sans, S, Padró, T, Thorand, B, Meisinger, C, Kee, F, McKnight, A J, Palosaari, T, Kuulasmaa, K, Waldeyer, C, Zeller, T, Blankenberg, S, Koenig, W & on behalf of the BiomarCaRE consortium 2020, ' Contribution of cystatin C-and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts : the BiomarCaRE project ', BMC Medicine, vol. 18, no. 1, 300 . https://doi.org/10.1186/s12916-020-01776-7 BMC Med. 18:300 (2020) |
| Publisher Information: | Springer Science and Business Media LLC, 2020. |
| Publication Year: | 2020 |
| Subject Terms: | Male, Adverse Outcome, Chronic Kidney Disease, Cohort Study, Creatinine, Cystatin C, Estimated Glomerular Filtration Rate, Coronary Disease, Risk Assessment, Adverse outcome, 03 medical and health sciences, 0302 clinical medicine, Creatinin-Clearance, Chronic kidney disease, Humans, name=SDG 3 - Good Health and Well-being, Estimated glomerular filtration rate, name=General Medicine, 2. Zero hunger, ddc:610, Renal insufficiency, Chronic, Klinisk medicin, Female [MeSH], Cohort study, Risk Assessment [MeSH], Humans [MeSH], Creatinine/metabolism [MeSH], Middle Aged [MeSH], Coronary Disease/pathology [MeSH], Coronary Disease/etiology [MeSH], Heart Disease Risk Factors [MeSH], Cystatin C/metabolism [MeSH], Male [MeSH], Prognosis [MeSH], Cardiovascular Diseases/mortality [MeSH], Research Article, Kohortenanalyse, Middle Aged, Prognosis, 16. Peace & justice, 3. Good health, Cardiovascular Diseases, Heart Disease Risk Factors, Cohort studies, Medicine, Female, Nierenkrankheit, Clinical Medicine, Cystatine |
| Description: | Background Chronic kidney disease has emerged as a strong cardiovascular risk factor, and in many current guidelines, it is already considered as a coronary heart disease (CHD) equivalent. Routinely, creatinine has been used as the main marker of renal function, but recently, cystatin C emerged as a more promising marker. The aim of this study was to assess the comparative cardiovascular and mortality risk of chronic kidney disease (CKD) using cystatin C-based and creatinine-based equations of the estimated glomerular filtration rate (eGFR) in participants of population-based and disease cohorts. Methods The present study has been conducted within the BiomarCaRE project, with harmonized data from 20 population-based cohorts (n = 76,954) from 6 European countries and 3 cardiovascular disease (CVD) cohorts (n = 4982) from Germany. Cox proportional hazards models were used to assess hazard ratios (HRs) for the various CKD definitions with adverse outcomes and mortality after adjustment for the Systematic COronary Risk Evaluation (SCORE) variables and study center. Main outcome measures were cardiovascular diseases, cardiovascular death, and all-cause mortality. Results The overall prevalence of CKD stage 3–5 by creatinine- and cystatin C-based eGFR, respectively, was 3.3% and 7.4% in the population-based cohorts and 13.9% and 14.4% in the disease cohorts. CKD was an important independent risk factor for subsequent CVD events and mortality. For example, in the population-based cohorts, the HR for CVD mortality was 1.72 (95% CI 1.53 to 1.92) with creatinine-based CKD and it was 2.14 (95% CI 1.90 to 2.40) based on cystatin-based CKD compared to participants without CKD. In general, the HRs were higher for cystatin C-based CKD compared to creatinine-based CKD, for all three outcomes and risk increased clearly below the conventional threshold for CKD, also in older adults. Net reclassification indices were larger for a cystatin-C based CKD definition. Differences in HRs (between the two CKD measures) in the disease cohorts were less pronounced than in the population-based cohorts. Conclusion CKD is an important risk factor for subsequent CVD events and total mortality. However, point estimates of creatinine- and cystatin C-based CKD differed considerably between low- and high-risk populations. Especially in low-risk settings, the use of cystatin C-based CKD may result in more accurate risk estimates and have better prognostic value. |
| Document Type: | Article Conference object Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1741-7015 |
| DOI: | 10.1186/s12916-020-01776-7 |
| DOI: | 10.18725/oparu-37875 |
| Access URL: | https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-020-01776-7 https://pubmed.ncbi.nlm.nih.gov/33161898 https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=1280 https://doaj.org/article/d68dccbed27a458fa73a0e537a30d3e6 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01776-7 https://oparu.uni-ulm.de/xmlui/handle/123456789/37937 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650190 https://europepmc.org/article/MED/33161898 https://link.springer.com/article/10.1186/s12916-020-01776-7 https://link.springer.com/content/pdf/10.1186/s12916-020-01776-7.pdf https://ddd.uab.cat/record/284415 https://pure.qub.ac.uk/en/publications/eb33b73b-7e97-4cf1-818d-9fda7e3a7139 https://curis.ku.dk/ws/files/255731737/s12916_020_01776_7.pdf https://push-zb.helmholtz-muenchen.de/frontdoor.php?source_opus=60498 https://repository.publisso.de/resource/frl:6464211 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-177739 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....bcdf0d689abb44cc95c0894b2b90a971 |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Background Chronic kidney disease has emerged as a strong cardiovascular risk factor, and in many current guidelines, it is already considered as a coronary heart disease (CHD) equivalent. Routinely, creatinine has been used as the main marker of renal function, but recently, cystatin C emerged as a more promising marker. The aim of this study was to assess the comparative cardiovascular and mortality risk of chronic kidney disease (CKD) using cystatin C-based and creatinine-based equations of the estimated glomerular filtration rate (eGFR) in participants of population-based and disease cohorts. Methods The present study has been conducted within the BiomarCaRE project, with harmonized data from 20 population-based cohorts (n = 76,954) from 6 European countries and 3 cardiovascular disease (CVD) cohorts (n = 4982) from Germany. Cox proportional hazards models were used to assess hazard ratios (HRs) for the various CKD definitions with adverse outcomes and mortality after adjustment for the Systematic COronary Risk Evaluation (SCORE) variables and study center. Main outcome measures were cardiovascular diseases, cardiovascular death, and all-cause mortality. Results The overall prevalence of CKD stage 3–5 by creatinine- and cystatin C-based eGFR, respectively, was 3.3% and 7.4% in the population-based cohorts and 13.9% and 14.4% in the disease cohorts. CKD was an important independent risk factor for subsequent CVD events and mortality. For example, in the population-based cohorts, the HR for CVD mortality was 1.72 (95% CI 1.53 to 1.92) with creatinine-based CKD and it was 2.14 (95% CI 1.90 to 2.40) based on cystatin-based CKD compared to participants without CKD. In general, the HRs were higher for cystatin C-based CKD compared to creatinine-based CKD, for all three outcomes and risk increased clearly below the conventional threshold for CKD, also in older adults. Net reclassification indices were larger for a cystatin-C based CKD definition. Differences in HRs (between the two CKD measures) in the disease cohorts were less pronounced than in the population-based cohorts. Conclusion CKD is an important risk factor for subsequent CVD events and total mortality. However, point estimates of creatinine- and cystatin C-based CKD differed considerably between low- and high-risk populations. Especially in low-risk settings, the use of cystatin C-based CKD may result in more accurate risk estimates and have better prognostic value. |
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| ISSN: | 17417015 |
| DOI: | 10.1186/s12916-020-01776-7 |