Association Of Kidney Damage With All-cause Mortality And Cardiovascular Events Among A Community-based Chinese Population

BackgroundsChronic kidney disease (CKD) is an important public health issue, which affects approximately10.0%-16.0%of adults worldwidely. It is now recognized that CKD is a risk factor for all-cause mortality and cardiovascular events in developed countries. However, the longitudinal studies from asian countries were limited, especially among community-based population. In the present study, we prospectively investigated the association between the indicator of kidney damage and all-cause mortality as well as cardiovascular (CV) events among a community-based Chinese population with normal or mildly impaired kidney function.MethodsThis prospective cohort study included1189residents aged60.1±9.4years from an urban district of Beijing, China. All participants had estimated glomerular filtration rate (eGFR) above30mL/min/1.73m2. Urinary albumin-to-creatinine ratio (ACR) and eGFR were assessed at baseline, and their association with future cardiovascular (CV) events and all-cause mortality after a6-year follow-up were analyzed.ResultsDuring6years of follow-up,87participants (7.3%) died and109participants reported CV events. After adjusting for potential confounders, eGFR and albuminuria were independently associated with all-cause mortality and CV events, respectively. Compared with eGFR>90ml/min per1.73m2,the multivariable-adjusted odds ratio (OR) of eGFR<60ml/min per1.73m2for all-cause mortality and CV events was2.31(95%CI,0.89-6.01) and2.73(95%CI,1.20-6.17).The multivariable-adjusted OR of ACR(every l0mg/g increase) for all-cause mortality and CV events was1.05(95%CI,1.02-1.10) and1.02(95%CI,1.00-1.04). Receiver operating characteristic curve showed the cut-off values of ACR with maximal Youden index for the prediction of all-cause mortality and CV events was3.61mg/g creatinine and2.99mg/g creatinine.ConclusionIncreased urinary ACR and reduced eGFR are both independently associated with CV events and all-cause mortality among a community-based Chinese population.