PMID- 37130317
OWN - NLM
STAT- MEDLINE
DCOM- 20230622
LR  - 20230626
IS  - 1557-8518 (Electronic)
IS  - 1540-4196 (Linking)
VI  - 21
IP  - 5
DP  - 2023 Jun
TI  - The Bidirectional Association of Chronic Kidney Disease, Type 2 Diabetes, 
      Atherosclerotic Cardiovascular Disease, and Heart Failure: The 
      Cardio-Renal-Metabolic Syndrome.
PG  - 261-266
LID - 10.1089/met.2023.0006 [doi]
AB  - Background: The cardiometabolic syndrome focuses on the association between type 
      2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD), 
      whereas the cardiorenal syndrome focuses on the association between chronic 
      kidney disease (CKD) and heart failure (HF). Consideration of these two syndromes 
      as a single entity has not been well described. Methods: We used the electronic 
      medical records of Kaiser Permanente Northwest to identify 387,985 members aged 
      18+ years with a serum creatinine measured from 2005 to 2017. If the estimated 
      glomerular filtration rate was <60 mL/min per 1.73 m(2), we required a second 
      confirmatory measurement 3-12 months later. Patients were followed through 2019. 
      We calculated the age- and gender-adjusted incidence and progression of CKD per 
      1000 person-years using generalized estimating equations. We used Cox 
      proportional hazard models to assess the time-dependent effect of each condition 
      on incidence of the other conditions. Results: CKD incidence rates were highest 
      in patients with T2DM, ASCVD, and HF (27.0 per 1000 person-years [95% confidence 
      interval (CI) 24.8-29.4] vs. 5.9 [5.8-6.0] in patients with none of these 
      conditions). Similar results were obtained for CKD progression (309.0, 
      283.9-336.4 for all three conditions vs. 147.9, 143.3-152.4 for no condition). In 
      time-dependent models, all three conditions were independently associated with 
      CKD incidence, being highest for HF (hazard ratio 2.14, 95% CI 2.07-2.21). All 
      relationships between CKD, T2DM, ASCVD, and HF were significant and 
      bidirectional. Conclusions: The presence of CKD, T2DM, HF, and ASCVD each conveys 
      risk on the others. A cardiometabolic renal syndrome comprising these conditions 
      may be an important disease entity that requires a comprehensive treatment 
      approach.
FAU - Nichols, Gregory A
AU  - Nichols GA
AUID- ORCID: 0000-0002-7563-6236
AD  - Kaiser Permanente Center for Health Research, Portland, Oregon, USA.
FAU - Amitay, Efrat L
AU  - Amitay EL
AD  - Global Medical Affairs, Boehringer Ingelheim International GmbH, Ingelheim, 
      Germany.
FAU - Chatterjee, Satabdi
AU  - Chatterjee S
AD  - Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals, 
      Inc., Ridgefield, Connecticut, USA.
FAU - Steubl, Dominik
AU  - Steubl D
AD  - Global Medical Affairs, Boehringer Ingelheim International GmbH, Ingelheim, 
      Germany.
AD  - Department of Nephrology, Klinikum Rechts der Isar, Technical University, Munich, 
      Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230502
PL  - United States
TA  - Metab Syndr Relat Disord
JT  - Metabolic syndrome and related disorders
JID - 101150318
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - *Cardio-Renal Syndrome/diagnosis/epidemiology/complications
MH  - *Cardiovascular Diseases/complications
MH  - *Metabolic Syndrome/complications/diagnosis/epidemiology
MH  - *Heart Failure/epidemiology
MH  - *Renal Insufficiency, Chronic/complications/diagnosis/epidemiology
MH  - *Atherosclerosis/complications/epidemiology
MH  - Glomerular Filtration Rate
OTO - NOTNLM
OT  - atherosclerotic cardiovascular disease
OT  - chronic kidney disease
OT  - epidemiology
OT  - heart failure
OT  - type 2 diabetes
EDAT- 2023/05/02 18:41
MHDA- 2023/06/22 06:42
CRDT- 2023/05/02 15:33
PHST- 2023/06/22 06:42 [medline]
PHST- 2023/05/02 18:41 [pubmed]
PHST- 2023/05/02 15:33 [entrez]
AID - 10.1089/met.2023.0006 [doi]
PST - ppublish
SO  - Metab Syndr Relat Disord. 2023 Jun;21(5):261-266. doi: 10.1089/met.2023.0006. 
      Epub 2023 May 2.