Heart Failure in a Cohort of Patients with Chronic Kidney Disease: The GCKD Study

被引:19
作者
Beck, Hanna [1 ]
Titze, Stephanie I. [2 ]
Huebner, Silvia [2 ]
Busch, Martin [3 ]
Schlieper, Georg [4 ]
Schultheiss, Ulla T. [1 ]
Wanner, Christoph [5 ,6 ]
Kronenberg, Florian [7 ]
Krane, Vera [5 ,6 ]
Eckardt, Kai-Uwe [2 ]
Koettgen, Anna [1 ]
机构
[1] Univ Freiburg, Med Ctr, Div Nephrol, Dept Med, D-79106 Freiburg, Germany
[2] Univ Erlangen Nurnberg, Dept Hypertens & Nephrol, D-91054 Erlangen, Germany
[3] Univ Jena, Dept Internal Med 3, Jena, Germany
[4] Rhein Westfal TH Aachen, Fac Med, Div Nephrol & Clin Immunol, Aachen, Germany
[5] Univ Wurzburg, Div Nephrol, Dept Internal Med 1, Wurzburg, Germany
[6] Univ Wurzburg, Comprehens Heart Failure Ctr, Wurzburg, Germany
[7] Med Univ Innsbruck, Div Genet Epidemiol, Dept Med Genet Mol & Clin Pharmacol, A-6020 Innsbruck, Austria
来源
PLOS ONE | 2015年 / 10卷 / 04期
关键词
CARDIOVASCULAR-DISEASE; ATHEROSCLEROSIS RISK; MEN BORN; EPIDEMIOLOGY; INSUFFICIENCY; POPULATION; DIAGNOSIS; DEATH; CLASSIFICATION; ASSOCIATION;
D O I
10.1371/journal.pone.0122552
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background and Aims Chronic kidney disease (CKD) is a risk factor for development and progression of heart failure (HF). CKD and HF share common risk factors, but few data exist on the prevalence, signs and symptoms as well as correlates of HF in populations with CKD of moderate severity. We therefore aimed to examine the prevalence and correlates of HF in the German Chronic Kidney Disease (GCKD) study, a large observational prospective study. Methods and Results We analyzed data from 5,015 GCKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) of <60 ml/min/1.73m(2) or with an eGFR >= 60 and overt proteinuria (>500 mg/d). We evaluated a definition of HF based on the Gothenburg score, a clinical HF score used in epidemiological studies (Gothenburg HF), and self-reported HF. Factors associated with HF were identified using multivariable adjusted logistic regression. The prevalence of Gothenburg HF was 43% (ranging from 24% in those with eGFR >90 to 59% in those with eGFR<30 ml/min/1.73m2). The corresponding estimate for self-reported HF was 18% (range 5%-24%). Lower eGFR was significantly and independently associated with the Gothenburg definition of HF (p-trend <0.001). Additional significantly associated correlates included older age, female gender, higher BMI, hypertension, diabetes mellitus, valvular heart disease, anemia, sleep apnea, and lower educational status. Conclusions The burden of self-reported and Gothenburg HF among patients with CKD is high. The proportion of patients who meet the criteria for Gothenburg HF in a European cohort of patients with moderate CKD is more than twice as high as the prevalence of self-reported HF. However, because of the shared signs, symptoms and medications of HF and CKD, the Gothenburg score cannot be used to reliably define HF in CKD patients. Our results emphasize the need for early screening for HF in patients with CKD.
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页数:15
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