Clinical and experimental nephrology · 2025
Combined effect of hyperhomocysteinemia and mild-to-moderate chronic kidney disease on mortality and cardiovascular events in the Japanese general population: the Yamagata (Takahata) study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Takehara Tomohiro, Otaki Yoichiro, Matsuo Kai, Goto Tetsuro, Kuramasu Yuzuka, Suzuki Takaya, Miyata Masahiro, Nawano Takaaki, Matsuki Eri, Watanabe Sayumi, Kamei Keita, Suzuki Natsuko, Ichikawa Kazunobu, Watanabe Tetsu, Konta Tsuneo, Watanabe Masafumi
Аннотация
BACKGROUND: Hyperhomocysteinemia (HHcy) and chronic kidney disease (CKD) are risk factors for cardiovascular events and all-cause mortality. Although their coexistence may further amplify these risks, few studies have evaluated this association, particularly in patients with mild-to-moderate CKD.
METHODS: In this retrospective analysis of prospective observational cohort, we analyzed data from 3,377 residents aged ≥ 40 years living in Takahata, Japan. Baseline data were collected between 2004 and 2006. Eligibility for inclusion required an estimated GFR of ≥ 30 mL/min/1.73 m2 at baseline. Primary and secondary endpoints were all-cause mortality and cardiovascular events, respectively. We assessed whether a combination of HHcy and mild-to-moderate CKD could predict these outcomes.
RESULTS: Median follow-up period was 18.6 years (interquartile range: 17.2-19.3). The Kaplan-Meier analyses revealed that individuals with both HHcy and CKD had the highest incidence of all-cause mortality and cardiovascular events (log-rank p < 0.001 for both). After adjusting for cardiovascular risk factors, this group remained at the highest risk, with hazard ratios of 2.49 and 2.11 and 95% confidence intervals of 2.00-3.10 and 1.32-3.38 for all-cause mortality and cardiovascular events, respectively.
CONCLUSION: In the Japanese general population aged ≥ 40 years, the coexistence of HHcy and mild-to-moderate CKD was associated with a significantly higher risk of all-cause mortality and cardiovascular events than either condition alone.
METHODS: In this retrospective analysis of prospective observational cohort, we analyzed data from 3,377 residents aged ≥ 40 years living in Takahata, Japan. Baseline data were collected between 2004 and 2006. Eligibility for inclusion required an estimated GFR of ≥ 30 mL/min/1.73 m2 at baseline. Primary and secondary endpoints were all-cause mortality and cardiovascular events, respectively. We assessed whether a combination of HHcy and mild-to-moderate CKD could predict these outcomes.
RESULTS: Median follow-up period was 18.6 years (interquartile range: 17.2-19.3). The Kaplan-Meier analyses revealed that individuals with both HHcy and CKD had the highest incidence of all-cause mortality and cardiovascular events (log-rank p < 0.001 for both). After adjusting for cardiovascular risk factors, this group remained at the highest risk, with hazard ratios of 2.49 and 2.11 and 95% confidence intervals of 2.00-3.10 and 1.32-3.38 for all-cause mortality and cardiovascular events, respectively.
CONCLUSION: In the Japanese general population aged ≥ 40 years, the coexistence of HHcy and mild-to-moderate CKD was associated with a significantly higher risk of all-cause mortality and cardiovascular events than either condition alone.