MO502
EGFR TRAJECTORY AND RISKS OF CARDIOVASCULAR EVENTS AND ENDSTAGING KIDNEY DISEASE IN CKD PATIENTS

Growing evidence has shown the eGFR level is an established predictor of cardiovascular events, but the association of eGFR trajectory with cardiovascular and renal events remained limited.

We conducted a retrospective cohort study on 276 CKD patients in whom at least two measurements of eGFR levels to calculate eGFR slope were confirmed. Patients were divided into two groups according to the below and above cut-off values of eGFR slopes for outcomes using ROC curve. Outcomes are cardiovascular events defined as heart failure requiring hospitalization, revascularization for IHD and PAD, stroke or sudden death, and renal events defined as ESRD or baseline eGFR decline of > 30%.

In total, the median (IQR) age of participants was 68 (56∼77) years and 176 (64%) were male. The median (IQR) levels of baseline eGFR were 33 (20∼48) mL/min/1.73m² with the median eGFR slope of -5.2(-0.85∼-9.5) mL/min/1.73m²/yr. During the study period, 92 cardiovascular events and 89 renal events occurred. Crude Kaplan-Meier analysis showed participants with lower eGFR slopes had higher probabilities of cardiovascular and renal events with statistical significances (p<0.001 and p<0.001, respectively). In the fully adjusted model, having lower eGFR slopes were associated with HRs (95%CIs) for cardiovascular and renal events of 1.71 [1.08-2.70] and 1.79 [1.09-2.93], respectively.

These data suggest not only current eGFR but also eGFR trajectory is an independent risk factor for cardiovascular and renal events in CKD patients.