Background
Methods
Patient population and study setting
Data collection
Presence of CKD
Outcome (awareness)
Covariates
Statistical methods
Results
Prevalence of impaired kidney function during the (index) hospital stay
Normal kidney function n = 362 (67.8%) | Impaired kidney function n = 172 (32.2%) |
p-value | |
---|---|---|---|
Age, years | 64.0 (58.5; 70.4) | 72.0 (65.7; 75.1) | <0.001 |
Male sex | 301 (83.2%) | 139 (80.8%) | 0.51 |
Length of hospital stay (days) | 3 (1; 7) | 8 (3; 11) | <0.001 |
Details of CHD event during index hospital stay | |||
AMI, any | 128 (35.5%) | 75 (43.6%) | 0.07 |
NSTEMI | 53 (41.4%) | 33 (44.0%) | 0.26 |
STEMI | 60 (46.9%) | 28 (37.3%) | |
Unclear/missing | 15 (11.7%) | 14 (18.7%) | |
Therapy (max.) | <0.001 | ||
Conservative (no intervention) | 54 (14.9%) | 29 (16.9%) | |
PCI/stent | 279 (77.1%) | 88 (51.2%) | |
CABG | 29 (8.0%) | 55 (32.0%) | |
CHD history | |||
Index event as the primary diagnosis of CHD | 162 (44.8%) | 64 (37.2%) | 0.10 |
In those with h/o CHD | |||
Duration of CHD, yrs. | 1.4 (0.4; 9.0) | 5.9 (0.6; 16.3) | <0.01 |
CABG (prior to index) | 35 (17.5%) | 21 (19.4%) | 0.67 |
PCI/stent (prior to index) | 101 (50.5%) | 55 (50.9%) | 0.94 |
MI (prior to index) | 125 (62.5%) | 65 (60.2%) | 0.69 |
History of heart failurea
| 117 (32.7%) | 82 (48.0%) | <0.001 |
Classic cardiovascular risk factors | |||
Diabetesb
| 98 (27.2%) | 51 (30.2%) | 0.47 |
Hypertensionb
| 299 (84.2%) | 142 (86.6%) | 0.48 |
Hyperlipidemiab
| 237 (67.1%) | 112 (70.0%) | 0.52 |
Smokingb
| 76 (22.8%) | 28 (18.9%) | 0.33 |
Obesityc
| 145 (41.1%) | 75 (47.5%) | 0.18 |
Kidney function | |||
SCr at admissiond, mg/dl | 0.9 (0.8; 1.0) | 1.2 (0.9; 1.3) | <0.001 |
eGFR at admission, ml/min/1.73m2
| 86.3 (74.9; 96.3) | 59.2 (51.3; 80.5) | <0.001 |
SCr at dischargee, mg/dl | 0.9 (0.8; 1.0) | 1.2 (1.0; 1.4) | <0.001 |
eGFR at discharge, ml/min/1.73m2
| 85.2 (74.6; 93.8) | 57.5 (49.0; 73.8) | <0.001 |
Physician’s awareness of kidney disease during the (index) hospital stay
Univariable | Multivariableb
| |||
---|---|---|---|---|
OR (95% CI) |
p-value | OR (95% CI) |
p-value | |
Patient’s age (index) [per year] | 1.06 (1.01; 1.11) | <0.01 | 0.98 (0.92;1.04) | 0.56 |
Patient’s sex [male vs. female] | 1.10 (0.44; 2.72) | 0.84 | – | – |
Length of hospital stay [log(d)] | 1.58 (1.15; 2.18) | <0.01 | 1.25 (0.83; 1.89) | 0.29 |
Therapy (max.) [vs. no intervention)] | 0.10 | – | – | |
PCI/stent vs. conservative | ||||
CABG vs. conservative | 0.49 (0.21; 1.12) | |||
1.07 (0.39; 2.96) | ||||
AMI during hospital stay | 1.49 (0.76; 2.94) | 0.24 | – | – |
Index hospital stay as primary CHD event [yes vs. no] | 0.32 (0.14; 0.75) | <0.01 | 0.38 (0.14; 1.00) | 0.05 |
History of CHFc
| 1.12 (0.56; 2.21) | 0.76 | – | – |
Cardiovascular risk factors | ||||
Diabetesd (index) | 2.57 (1.30; 5.07) | <0.01 | 1.85 (0.77; 4.44) | 0.17 |
Hypertensiond (index) | 2.12 (0.63; 7.09) | 0.22 | – | – |
Hyperlipidemiad (index) | 2.21 (0.95; 5.17) | 0.07 | – | – |
Smoking (index)d
| 0.35 (0.10; 1.16) | 0.08 | – | – |
Obesitye (index) | 2.23 (1.11; 4.48) | 0.02 | 1.34 (0.58; 3.11) | 0.49 |
Kidney function | ||||
eGFR at discharge [per ml/min/1.73m2] | 0.93 (0.91; 0.95) | <0.001 | 0.92 (0.89; 0.94) | <0.001 |
AKI-stages [vs.no AKI]f
| <0.001 | <0.001 | ||
Stage 1 [vs. no AKI] | 1.51 (0.59; 3.85) | 0.38 (0.12; 1.22) | ||
Stage 2/3 [vs. no AKI] | 54.7 (10.8; 277.7) | 92.7 (10.1; 847.9) |
Prevalence of chronic kidney disease at the study visit
normal kidney function n = 345 (65.1%) | chronic kidney disease n = 185 (34.9%) |
p-value | |
---|---|---|---|
Age, yrs | 65.4 (59.6; 72.2) | 73.4 (66.5; 77.0) | <0.001 |
Male gender | 291 (84.4%) | 145 (78.4%) | 0.09 |
Total year in education, yrs | 12 (11; 15) | 11 (11; 14) | <0.001 |
Education level (higher vs. lower levelsb) | 72 (20.9%) | 27 (14.6%) | 0.08 |
History of CHD | |||
Duration of CHD | 2.7 (1.9; 6.4) | 3.4 (2.0; 12.9) | <0.01 |
CHD history | |||
- CABG | 77 (22.3%) | 59 (31.9%) | 0.02 |
- PCI/stent | 278 (78.6%) | 138 (74.6%) | 0.12 |
- AMI | 131 (38.0%) | 49 (42.7%) | 0.30 |
History of heart failure | 40 (11.6%) | 38 (20.7%) | <0.01 |
History of stroke | 33 (9.8%) | 22 (11.9%) | 0.45 |
History of peripheral artery disease | 18 (5.2%) | 29 (15.7%) | <0.001 |
Classic CV risk factors | |||
BMI [kg/m2] | 28.0 (25.9; 30.7) | 29.5 (27.0; 32.8) | <0.001 |
Overweight (BMI ≥25) | 281 (82.2%) | 168 (91.3%) | <0.01 |
Obesity (BMI ≥30) | 105 (30.7%) | 86 (46.7%) | <0.001 |
Blood pressure | |||
Systolic | 133 (122; 148) | 138 (128; 152) | <0.01 |
Diastolic | 80 (73; 87) | 81 (73; 88) | 0.67 |
Hypertensionc
| 142 (41.2%) | 96 (52.2%) | 0.02 |
LDL-cholesterol (mmol/l) | 2.59 (2.16; 3.14) | 2.43 (1.98; 2.98) | 0.02 |
Hyperlipidemia | |||
LDL cholesterol ≥2.5 mmol/l | 188 (56.1%) | 77 (45.6%) | 0.03 |
LDL cholesterol ≥1.8 mmol/l | 307 (91.6%) | 143 (84.6%) | 0.02 |
Diabetesd
| 70 (20.5%) | 75 (41.4%) | <0.001 |
Smokinge
| 49 (14.2%) | 14 (7.6%) | 0.02 |
Chronic kidney disease | |||
SCrstudy-visit (mg/dl) | 1.0 (0.8; 1.0) | 1.2 (1.1; 1.4) | <0.001 |
eGFRCKD-EPI (ml/min/1.73m2) | 81.0 (71.2; 90.4) | 53.9 (46.6; 62.6) | <0.001 |
ACRstudy-visit (mg/g) | 2.9 (0; 7.4) | 20.4 (5.0; 78.5) | <0.001 |
Information on impaired kidney function in a discharge letter of a hospital stay due to CHDf
| 6 (1.9%) | 31 (19.0%) | <0.001 |
Patients’ awareness of chronic kidney disease at the study visit
CKD G stages at EUROASPIRE IV study visita
| ||||||||
---|---|---|---|---|---|---|---|---|
G1 | G2 | G3a (n = 83) | G3b (n = 18) | G4 (n = 7) | G5 (n = 1) | |||
All patients (n = 84) | Patients with impaired kidney functionb (n = 1) | All patients (n = 275) | Patients with impaired kidney functionb (n = 47) | |||||
Ever been told by a doctor about impaired kidney function | 2 (2.4%) | 0 | 24 (8.7%) | 7 (14.9%) | 33 (39.8%) | 7 (38.9%) | 6 (85.7%) | 1 (100%) |
Recommendation to seek professional advice/referred to kidney specialistc
| 1 (1.2%) | 0 | 12 (4.4%) | 2 (4.3%) | 11 (13.3%) | 5 (27.8%) | 4 (57.1%) | 1 (100%) |
Seen by a kidney specialistc
| 1 (1.2%) | 0 | 13 (4.7%) | 2 (4.3%) | 9 (10.8%) | 4 (22.2%) | 5 (71.4%) | 1 (100%) |
Univariable | Multivariableb
| |||
---|---|---|---|---|
OR (95% CI) |
P
| OR (95% CI) |
P
| |
Age, [/yr] | 1.05 (1.02; 1.08) | <0.01 |
0.97 (0.93; 1.01)
|
0.18
|
Male gender [vs. female] | 0.59 (0.33; 1.07) | 0.08 | – | |
Education | ||||
Total years [/log(yr)] | 0.65 (0.28; 1.50) | 0.32 | – | |
Higher vs. lower levelsc
| 0.57 (0.27; 1.20) | 0.14 | – | |
Information on impaired kidney function in a discharge letter of a hospital stay due to CHDd
| 15.8 (7.45; 33.7) | <0.001 | 5.51 (2.35; 12.9) | <0.001 |
Primary care for CHD provided by cardiologist [vs. non-cardiologist] | 0.88 (0.52; 1.48) | 0.62 | – | – |
History of CHD | ||||
CHD duration [/log(yr)] | 1.30 (1.01; 1.66) | 0.04 |
0.89 (0.64; 1.23)
|
0.47
|
CABG ever | 1.52 (0.88; 2.63) | 0.13 | – | – |
History of heart failure | 2.43 (1.36; 4.34) | <0.01 | 1.99 (1.00; 3.97) | 0.05 |
History of peripheral artery disease | 2.19 (1.07; 4.48) | 0.03 |
0.83 (0.31; 2.19)
|
0.71
|
Diabetese
| 1.23 (0.71; 2.13) | 0.45 | – | |
Smokingf
| 0.81 (0.37; 1.78) | 0.60 | – | |
Dyslipidemiag
| 1.37 (0.80; 2.34) | 0.25 | – | |
Obesityh
| 1.93 (1.16; 3.21) | 0.01 | 1.97 (1.07; 3.64) | 0.03 |
eGFRCKD_EPI at study visit [/ml/min/1.73m2] | 0.93 (0.91; 0.95) | <0.001 | 0.94 (0.92; 0.96) | <0.001 |
ACR at study visit [/ log(mg/g)] | 1.09 (1.01; 1.17) | 0.02 |
0.99 (0.91; 1.08)
|
0.88
|