Risk of end-stage renal disease in patients with hypertrophic cardiomyopathy: A nationwide population-based cohort study

被引:18
|
作者
Lee, Heesun [1 ,2 ]
Han, Kyungdo [3 ]
Park, Jun-Bean [1 ,4 ]
Hwang, In-Chang [1 ,5 ]
Yoon, Yeonyee E. [1 ,5 ]
Park, Hyo Eun [1 ,2 ]
Choi, Su-Yeon [1 ,2 ]
Kim, Yong-Jin [1 ,4 ]
Cho, Goo-Yeong [1 ,5 ]
Kim, Hyung-Kwan [1 ,4 ]
Ommen, Steve R. [6 ]
机构
[1] Seoul Natl Univ, Coll Med, Dept Internal Med, Div Cardiol, 101 Daehak Ro, Seoul 03080, South Korea
[2] Seoul Natl Univ Hosp, Healthcare Syst Gangnam Ctr, Seoul, South Korea
[3] Catholic Univ Korea, Coll Med, Dept Med Stat, Seoul, South Korea
[4] Seoul Natl Univ Hosp, Cardiovasc Ctr, Cardiovasc Imaging Sect, 101 Daehak Ro, Seoul 03080, South Korea
[5] Seoul Natl Univ, Bundang Hosp, Cardiovasc Ctr, Dept Cardiol, Seongnam, Gyeonggi, South Korea
[6] Mayo Clin, Coll Med, Div Cardiovasc Dis, Rochester, MN USA
关键词
CHRONIC KIDNEY-DISEASE; HEART-FAILURE; MYOCARDIAL-INFARCTION; ECONOMIC BURDEN; PREVALENCE; INSUFFICIENCY; EPIDEMIOLOGY; ASSOCIATION; DEFINITION; DIAGNOSIS;
D O I
10.1038/s41598-019-50993-5
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
Although hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy, has mortality rate as low as general population, previous studies have focused on identifying high-risk of sudden cardiac death. Thus, long-term systemic impact of HCM is still unclear. We sought to investigate the association between HCM and end-stage renal disease (ESRD). This was a nationwide population-based cohort study using the National Health Insurance Service database. We investigated incident ESRD during follow-up in 10,300 adult patients with HCM (age 62.1 years, male 67.3%) and 51,500 age-, sex-matched controls. During follow-up (median 2.8 years), ESRD developed in 197 subjects; 111(1.08%) in the HCM, and 86 (0.17%) in the non-HCM (incidence rate 4.14 vs. 0.60 per 1,000 person-years, p < 0.001). In the HCM, the incidence rate for ESRD gradually increased with age, but an initial peak and subsequent plateau in age-specific risk were observed. HCM was a significant predictor for ESRD (unadjusted HR 6.90, 95%CI 5.21-9.15, p < 0.001), as comparable to hypertension and diabetes mellitus. Furthermore, after adjusting for all variables showing the association in univariate analysis, HCM itself remained a robust predictor of ESRD development (adjusted HR 3.93, 95% CI 2.82-5.46, p < 0.001). The consistent associations between HCM and ESRD were shown in almost all subgroups other than smokers and subjects with a history of stroke. Conclusively, HCM increased the risk of ESRD, regardless of known prognosticators. It provides new insight into worsening renal function in HCM, and active surveillance for renal function should be considered.
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页数:10
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