Cardiovascular disease burden attributable to estimated glomerular filtration rate: Insights from the ATTICA study (2002-2022).

PURPOSE: This study aimed to estimate cardiovascular disease (CVD) burden attributable to chronic kidney disease (CKD) and whether this burden varies in participants with different population characteristics.

METHODS

Our sample included 1988 adults free-of-CVD at baseline who took part in the ATTICA study (2002-2022). Estimated glomerular filtration rate (eGFR) was calculated based on the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined in 2002, according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines, as an eGFR ≤ 60 mL/min/1.73 m2. Combined fatal or non-fatal CVD events were assessed in 2006, 2012 and 2022 based on WHO-ICD-10. Population attributable fractions for multiadjusted models were computed based on Miettinen's formula. Stratified analyses were also performed.

RESULTS

At baseline, CKD prevalence was 4.7 % (n = 94). During the 20-year period, 36.1 % of participants developed CVD. A higher percentage of participants with CKD developed CVD compared to those without (77 % vs. 34 %). Approximately 6 out of a 100 new CVD cases (95 %CI: 1.7 %, 8.1 %) would have been prevented if CKD had been properly managed. Variations in these fractions were observed by sex and presence of comorbidities.

CONCLUSIONS

Albeit more research is warranted, our study supports that CKD should become a public health priority, and specifically a CVD priority.