Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts

Chronic kidney disease has emerged as a strong cardiovascular risk factor, and in many current guidelines, it is already considered as a coronary heart disease (CHD) equivalent. Routinely, creatinine has been used as the main marker of renal function, but recently, cystatin C emerged as a more promi...

Descripción completa

Detalles Bibliográficos
Autores: Rothenbacher, Dietrich|||0000-0002-3563-2791, Rehm, Martin, Iacoviello, Licia|||0000-0003-0514-5885, Costanzo, Simona|||0000-0003-4569-1186, Tunstall-Pedoe, Hugh|||0000-0001-8721-7058, Belch, Jill J.F.|||0000-0001-8280-6689, Söderberg, Stefan|||0000-0001-9225-1306, Hultdin, Johan|||0000-0002-9599-0961, Salomaa, Veikko|||0000-0001-7563-5324, Jousilahti, Pekka, Linneberg, Allan|||0000-0002-0994-0184, Sans, Susana|||0000-0002-0400-5197, Padró, Teresa|||0000-0003-1921-954X, Thorand, Barbara, Meisinger, C., Kee, Frank|||0000-0002-0606-8167, McKnight, Amy Jayne|||0000-0002-7482-709X, Palosaari, Tarja, Kuulasmaa, Kari|||0000-0003-2165-1411, Waldeyer, Christoph, Zeller, Tanja|||0000-0003-3379-2641, Blankenberg, Stefan|||0000-0001-6488-2362, Koenig, Wolfgang|||0000-0002-2064-9603
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284415
Acceso en línea:https://ddd.uab.cat/record/284415
https://dx.doi.org/urn:doi:10.1186/s12916-020-01776-7
Access Level:acceso abierto
Palabra clave:Adverse outcome
Chronic kidney disease
Cohort study
Creatinine
Cystatin C
Estimated glomerular filtration rate
id ES_70c19505fd708bb2e3b5cccc3c771d80
oai_identifier_str oai:ddd.uab.cat:284415
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
the BiomarCaRE project
title Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
spellingShingle Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
Rothenbacher, Dietrich|||0000-0002-3563-2791
Adverse outcome
Chronic kidney disease
Cohort study
Creatinine
Cystatin C
Estimated glomerular filtration rate
title_short Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
title_full Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
title_fullStr Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
title_full_unstemmed Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
title_sort Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts
dc.creator.none.fl_str_mv Rothenbacher, Dietrich|||0000-0002-3563-2791
Rehm, Martin
Iacoviello, Licia|||0000-0003-0514-5885
Costanzo, Simona|||0000-0003-4569-1186
Tunstall-Pedoe, Hugh|||0000-0001-8721-7058
Belch, Jill J.F.|||0000-0001-8280-6689
Söderberg, Stefan|||0000-0001-9225-1306
Hultdin, Johan|||0000-0002-9599-0961
Salomaa, Veikko|||0000-0001-7563-5324
Jousilahti, Pekka
Linneberg, Allan|||0000-0002-0994-0184
Sans, Susana|||0000-0002-0400-5197
Padró, Teresa|||0000-0003-1921-954X
Thorand, Barbara
Meisinger, C.
Kee, Frank|||0000-0002-0606-8167
McKnight, Amy Jayne|||0000-0002-7482-709X
Palosaari, Tarja
Kuulasmaa, Kari|||0000-0003-2165-1411
Waldeyer, Christoph
Zeller, Tanja|||0000-0003-3379-2641
Blankenberg, Stefan|||0000-0001-6488-2362
Koenig, Wolfgang|||0000-0002-2064-9603
author Rothenbacher, Dietrich|||0000-0002-3563-2791
author_facet Rothenbacher, Dietrich|||0000-0002-3563-2791
Rehm, Martin
Iacoviello, Licia|||0000-0003-0514-5885
Costanzo, Simona|||0000-0003-4569-1186
Tunstall-Pedoe, Hugh|||0000-0001-8721-7058
Belch, Jill J.F.|||0000-0001-8280-6689
Söderberg, Stefan|||0000-0001-9225-1306
Hultdin, Johan|||0000-0002-9599-0961
Salomaa, Veikko|||0000-0001-7563-5324
Jousilahti, Pekka
Linneberg, Allan|||0000-0002-0994-0184
Sans, Susana|||0000-0002-0400-5197
Padró, Teresa|||0000-0003-1921-954X
Thorand, Barbara
Meisinger, C.
Kee, Frank|||0000-0002-0606-8167
McKnight, Amy Jayne|||0000-0002-7482-709X
Palosaari, Tarja
Kuulasmaa, Kari|||0000-0003-2165-1411
Waldeyer, Christoph
Zeller, Tanja|||0000-0003-3379-2641
Blankenberg, Stefan|||0000-0001-6488-2362
Koenig, Wolfgang|||0000-0002-2064-9603
author_role author
author2 Rehm, Martin
Iacoviello, Licia|||0000-0003-0514-5885
Costanzo, Simona|||0000-0003-4569-1186
Tunstall-Pedoe, Hugh|||0000-0001-8721-7058
Belch, Jill J.F.|||0000-0001-8280-6689
Söderberg, Stefan|||0000-0001-9225-1306
Hultdin, Johan|||0000-0002-9599-0961
Salomaa, Veikko|||0000-0001-7563-5324
Jousilahti, Pekka
Linneberg, Allan|||0000-0002-0994-0184
Sans, Susana|||0000-0002-0400-5197
Padró, Teresa|||0000-0003-1921-954X
Thorand, Barbara
Meisinger, C.
Kee, Frank|||0000-0002-0606-8167
McKnight, Amy Jayne|||0000-0002-7482-709X
Palosaari, Tarja
Kuulasmaa, Kari|||0000-0003-2165-1411
Waldeyer, Christoph
Zeller, Tanja|||0000-0003-3379-2641
Blankenberg, Stefan|||0000-0001-6488-2362
Koenig, Wolfgang|||0000-0002-2064-9603
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Adverse outcome
Chronic kidney disease
Cohort study
Creatinine
Cystatin C
Estimated glomerular filtration rate
topic Adverse outcome
Chronic kidney disease
Cohort study
Creatinine
Cystatin C
Estimated glomerular filtration rate
description Chronic kidney disease has emerged as a strong cardiovascular risk factor, and in many current guidelines, it is already considered as a coronary heart disease (CHD) equivalent. Routinely, creatinine has been used as the main marker of renal function, but recently, cystatin C emerged as a more promising marker. The aim of this study was to assess the comparative cardiovascular and mortality risk of chronic kidney disease (CKD) using cystatin C-based and creatinine-based equations of the estimated glomerular filtration rate (eGFR) in participants of population-based and disease cohorts. The present study has been conducted within the BiomarCaRE project, with harmonized data from 20 population-based cohorts (n = 76,954) from 6 European countries and 3 cardiovascular disease (CVD) cohorts (n = 4982) from Germany. Cox proportional hazards models were used to assess hazard ratios (HRs) for the various CKD definitions with adverse outcomes and mortality after adjustment for the Systematic COronary Risk Evaluation (SCORE) variables and study center. Main outcome measures were cardiovascular diseases, cardiovascular death, and all-cause mortality. The overall prevalence of CKD stage 3-5 by creatinine- and cystatin C-based eGFR, respectively, was 3.3% and 7.4% in the population-based cohorts and 13.9% and 14.4% in the disease cohorts. CKD was an important independent risk factor for subsequent CVD events and mortality. For example, in the population-based cohorts, the HR for CVD mortality was 1.72 (95% CI 1.53 to 1.92) with creatinine-based CKD and it was 2.14 (95% CI 1.90 to 2.40) based on cystatin-based CKD compared to participants without CKD. In general, the HRs were higher for cystatin C-based CKD compared to creatinine-based CKD, for all three outcomes and risk increased clearly below the conventional threshold for CKD, also in older adults. Net reclassification indices were larger for a cystatin-C based CKD definition. Differences in HRs (between the two CKD measures) in the disease cohorts were less pronounced than in the population-based cohorts. CKD is an important risk factor for subsequent CVD events and total mortality. However, point estimates of creatinine- and cystatin C-based CKD differed considerably between low- and high-risk populations. Especially in low-risk settings, the use of cystatin C-based CKD may result in more accurate risk estimates and have better prognostic value.
publishDate 2020
dc.date.none.fl_str_mv 2
2020-01-01
2020
2020-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/284415
https://dx.doi.org/urn:doi:10.1186/s12916-020-01776-7
url https://ddd.uab.cat/record/284415
https://dx.doi.org/urn:doi:10.1186/s12916-020-01776-7
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869410603299241984
spelling Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohortsthe BiomarCaRE projectRothenbacher, Dietrich|||0000-0002-3563-2791Rehm, MartinIacoviello, Licia|||0000-0003-0514-5885Costanzo, Simona|||0000-0003-4569-1186Tunstall-Pedoe, Hugh|||0000-0001-8721-7058Belch, Jill J.F.|||0000-0001-8280-6689Söderberg, Stefan|||0000-0001-9225-1306Hultdin, Johan|||0000-0002-9599-0961Salomaa, Veikko|||0000-0001-7563-5324Jousilahti, PekkaLinneberg, Allan|||0000-0002-0994-0184Sans, Susana|||0000-0002-0400-5197Padró, Teresa|||0000-0003-1921-954XThorand, BarbaraMeisinger, C.Kee, Frank|||0000-0002-0606-8167McKnight, Amy Jayne|||0000-0002-7482-709XPalosaari, TarjaKuulasmaa, Kari|||0000-0003-2165-1411Waldeyer, ChristophZeller, Tanja|||0000-0003-3379-2641Blankenberg, Stefan|||0000-0001-6488-2362Koenig, Wolfgang|||0000-0002-2064-9603Adverse outcomeChronic kidney diseaseCohort studyCreatinineCystatin CEstimated glomerular filtration rateChronic kidney disease has emerged as a strong cardiovascular risk factor, and in many current guidelines, it is already considered as a coronary heart disease (CHD) equivalent. Routinely, creatinine has been used as the main marker of renal function, but recently, cystatin C emerged as a more promising marker. The aim of this study was to assess the comparative cardiovascular and mortality risk of chronic kidney disease (CKD) using cystatin C-based and creatinine-based equations of the estimated glomerular filtration rate (eGFR) in participants of population-based and disease cohorts. The present study has been conducted within the BiomarCaRE project, with harmonized data from 20 population-based cohorts (n = 76,954) from 6 European countries and 3 cardiovascular disease (CVD) cohorts (n = 4982) from Germany. Cox proportional hazards models were used to assess hazard ratios (HRs) for the various CKD definitions with adverse outcomes and mortality after adjustment for the Systematic COronary Risk Evaluation (SCORE) variables and study center. Main outcome measures were cardiovascular diseases, cardiovascular death, and all-cause mortality. The overall prevalence of CKD stage 3-5 by creatinine- and cystatin C-based eGFR, respectively, was 3.3% and 7.4% in the population-based cohorts and 13.9% and 14.4% in the disease cohorts. CKD was an important independent risk factor for subsequent CVD events and mortality. For example, in the population-based cohorts, the HR for CVD mortality was 1.72 (95% CI 1.53 to 1.92) with creatinine-based CKD and it was 2.14 (95% CI 1.90 to 2.40) based on cystatin-based CKD compared to participants without CKD. In general, the HRs were higher for cystatin C-based CKD compared to creatinine-based CKD, for all three outcomes and risk increased clearly below the conventional threshold for CKD, also in older adults. Net reclassification indices were larger for a cystatin-C based CKD definition. Differences in HRs (between the two CKD measures) in the disease cohorts were less pronounced than in the population-based cohorts. CKD is an important risk factor for subsequent CVD events and total mortality. However, point estimates of creatinine- and cystatin C-based CKD differed considerably between low- and high-risk populations. Especially in low-risk settings, the use of cystatin C-based CKD may result in more accurate risk estimates and have better prognostic value.Universitat Autònoma de Barcelona 22020-01-0120202020-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/284415https://dx.doi.org/urn:doi:10.1186/s12916-020-01776-7reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2844152026-06-06T12:50:31Z
score 15,298079