L CUTHBERTSON1, E CASH1, L PRENTICE2, A BLACK1, J BURGESS1, K MACINTYRE2, T SAUNDER2, A KITSOS2, K JOSE3, R RAJ2, C MCKERCHER3, J RADFORD2, M JOSE1
1Royal Hobart Hospital, Hobart, Australia, 2School of Medicine, University of Tasmania, Hobart, Australia, 3Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
Aim: To report the rate of vascular events and death from cardiovascular causes in people living with chronic kidney disease (CKD).
Background: Cardiovascular (CV) disease increases as kidney function decreases. Identifying individuals or communities with a high prevalence of modifiable vascular risk factors for cardiovascular events may allow targeted interventions to improve longer-term health.
Methods: The CKD.TASlink study takes a state-wide approach using data linkage of five health (public hospital admissions, emergency presentations, ANZDATA, cancer and death registry) and two pathology (community and hospital) datasets. The study population consists of any adult who had a creatinine test between 1/1/2004 and 31/12/2017. We defined CKD as two measures of eGFR<60mL/min/1.73m2, at least 3-months apart. Major CV events (diagnosis, procedural ICD-10 code or CV- related death) were identified in the admitted patient dataset and data reported using age-standardised rate and relative risks (RR) without 95% confidence intervals (given whole of population approach).
Results: Of the study population (n=460,737 or 86.8% of the state’s population), 227,443 (49.4%) had at least one admission, including 41,455 with CKD. There were 187,085 CV events in 77,095 individuals, 12,634 procedures and 13,696 deaths. Compared to adults without CKD, adults with CKD were more likely have an admission (RR 1.6), a major CV event (RR 5.6), major CV procedure (RR 4.8), including percutaneous coronary intervention (RR 3.6), coronary artery bypass (RR 5.1), aortic valve surgery (RR 5.3) or pacemaker insertion (RR 11.4), and more likely to die (RR 5.9) within the study period.
Conclusions: CV events and procedures are more common in people with CKD than without CKD. Identification and optimal management of CKD may improve long-term health outcomes.
Dr Laura Cuthbertson is a Basic Physician Trainee at the Royal Hobart Hospital, Tasmania. Dr Cuthbertson completed medical school at the University of Tasmania in 2016 and is currently involved in several research projects focusing on renal and cardiovascular disease. Dr Cuthbertson was the recipient of the 2018 CPMEC Junior Doctor of the Year Award for Tasmania. Dr Cuthbertson would like to pursue a career in Nephrology.