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...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| 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 |
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España |
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| 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 |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf |
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reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
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Universitat Autònoma de Barcelona |
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Dipòsit Digital de Documents de la UAB |
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Dipòsit Digital de Documents de la UAB |
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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 |
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15,298079 |