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Abstract

Background and Aims

Cardiovascular mortality is high in chronic kidney disease (CKD) patients. Recognizing patients with higher cardiovascular risk might help in their treatment. CHA2DS2-VASc score was originally used to predict cerebral infarction in patients with atrial fibrillation (AF). However, it is also useful in predicting outcome in different cardiovascular conditions, independent of the presence of AF. Therefore, the aim of our research was to assess the role of CHA2DS2-VASc score in cardiovascular mortality in CKD patients.

Method

Eighty-seven non-dialysis CKD patients from our outpatient clinic were included. At the time of inclusion, medical history data and standard blood results were collected and CHA2DS2-VASc score was calculated. Patients were followed for assigned time or until their death. Mean follow-up time was 1696.45±564.60 days.

Results

Descriptive statistics of our patients are presented in table 1. During follow-up 11 patients suffered from cardiovascular death. Univariate Cox regression analysis showed that CHA2DS2-VASc score is a significant predictor of cardiovascular mortality (HR: 2.19, CI: 1.42-3.37, p=0.001). In multivariate Cox regression analysis in which CHA2DS2-VASc score, serum creatinine, urinary albumin/creatinine, haemoglobin, high sensitivity CRP and intact PTH were included, CHA2DS2-VASc score was an independent predictor of cardiovascular mortality (HR: 2.04, CI: 1.20-3.45, p=0.008) (table 2).

MO159   Table 1.
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Descriptive statistics of 87 CKD patients presented as mean±SD or as absolute number of patients with a known condition.

CKD patients (N=87)
Age (years)60.29±12.84
Sex - male/female57/30
Arterial hypertension85
Diabetes22
Dyslipidaemia43
Smoking - past or current39
CHA2DS2-VASc score2.49±1.40
Serum creatinine (µmol/l)260.40±134.69
eGFR (ml/min/1.73m2)29.50±22.54
Urinary albumin/creatinine (mg/g)935.75±1426.71
Haemoglobin (g/l)129.41±18.50
High sensitivity CRP (mg/l)5.27±9.14
Calcium (mmol/l)2.23±0.14
Phosphate (mmol/l)1.23±0.35
Intact PTH (pg/ml)139.10±110.52
CKD patients (N=87)
Age (years)60.29±12.84
Sex - male/female57/30
Arterial hypertension85
Diabetes22
Dyslipidaemia43
Smoking - past or current39
CHA2DS2-VASc score2.49±1.40
Serum creatinine (µmol/l)260.40±134.69
eGFR (ml/min/1.73m2)29.50±22.54
Urinary albumin/creatinine (mg/g)935.75±1426.71
Haemoglobin (g/l)129.41±18.50
High sensitivity CRP (mg/l)5.27±9.14
Calcium (mmol/l)2.23±0.14
Phosphate (mmol/l)1.23±0.35
Intact PTH (pg/ml)139.10±110.52
MO159   Table 1.
Open in new tab

Descriptive statistics of 87 CKD patients presented as mean±SD or as absolute number of patients with a known condition.

CKD patients (N=87)
Age (years)60.29±12.84
Sex - male/female57/30
Arterial hypertension85
Diabetes22
Dyslipidaemia43
Smoking - past or current39
CHA2DS2-VASc score2.49±1.40
Serum creatinine (µmol/l)260.40±134.69
eGFR (ml/min/1.73m2)29.50±22.54
Urinary albumin/creatinine (mg/g)935.75±1426.71
Haemoglobin (g/l)129.41±18.50
High sensitivity CRP (mg/l)5.27±9.14
Calcium (mmol/l)2.23±0.14
Phosphate (mmol/l)1.23±0.35
Intact PTH (pg/ml)139.10±110.52
CKD patients (N=87)
Age (years)60.29±12.84
Sex - male/female57/30
Arterial hypertension85
Diabetes22
Dyslipidaemia43
Smoking - past or current39
CHA2DS2-VASc score2.49±1.40
Serum creatinine (µmol/l)260.40±134.69
eGFR (ml/min/1.73m2)29.50±22.54
Urinary albumin/creatinine (mg/g)935.75±1426.71
Haemoglobin (g/l)129.41±18.50
High sensitivity CRP (mg/l)5.27±9.14
Calcium (mmol/l)2.23±0.14
Phosphate (mmol/l)1.23±0.35
Intact PTH (pg/ml)139.10±110.52
MO159   Table 2.
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Multivariate Cox regression analysis of factors related to cardiovascular death in CKD patients.

Hazard ratio95% confidence intervalp
CHA2DS2-VASc score2.041.20-3.450.008
Serum creatinine1.000.99-1.010.384
Urinary albumin/creatinine1.040.63-1.710.891
Haemoglobin0.950.90-1.000.051
High sensitivity CRP0.900.74-5.270.245
Intact PTH1.000.99-1.010.639
Hazard ratio95% confidence intervalp
CHA2DS2-VASc score2.041.20-3.450.008
Serum creatinine1.000.99-1.010.384
Urinary albumin/creatinine1.040.63-1.710.891
Haemoglobin0.950.90-1.000.051
High sensitivity CRP0.900.74-5.270.245
Intact PTH1.000.99-1.010.639
MO159   Table 2.
Open in new tab

Multivariate Cox regression analysis of factors related to cardiovascular death in CKD patients.

Hazard ratio95% confidence intervalp
CHA2DS2-VASc score2.041.20-3.450.008
Serum creatinine1.000.99-1.010.384
Urinary albumin/creatinine1.040.63-1.710.891
Haemoglobin0.950.90-1.000.051
High sensitivity CRP0.900.74-5.270.245
Intact PTH1.000.99-1.010.639
Hazard ratio95% confidence intervalp
CHA2DS2-VASc score2.041.20-3.450.008
Serum creatinine1.000.99-1.010.384
Urinary albumin/creatinine1.040.63-1.710.891
Haemoglobin0.950.90-1.000.051
High sensitivity CRP0.900.74-5.270.245
Intact PTH1.000.99-1.010.639
Conclusion

CHA2DS2-VASc score is a simple and quick way to identify cardiovascular risk in CKD patients.

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© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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Mini Orals (sorted by session) > Clinical nephrology
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