ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2022
Urea levels and cardiovascular disease in patients with chronic kidney disease.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Hydration Care After Stroke: A Systematic Review of International Clinical Practice Guidelines.Nutrients · 2026Pooled it
- Plasma Erythropoietin Levels and Anemia in Vietnamese Patients With Type 2 Diabetes and Chronic Kidney Disease: 2018-2019.Health science reports · 2026Article
- Dietary Protein Intake in CKD: Quantity and Quality.Clinical journal of the American Society of Nephrology : CJASN · 2026Review
- Hemodialysis-induced variability of the QRS-T spatial angle reveals distinct electrophysiological patterns in patients with end-stage renal disease.International urology and nephrology · 2026Article
- Interpretable machine learning of non-traditional lipid indices for diagnostic classification of CHD in patients with comorbid MASLD and T2DM: a multicenter study.Frontiers in nutrition · 2026Article
- Plasma asymmetric dimethylarginine and its association with cardiovascular risk factors in Vietnamese patients before and after kidney transplantation, 2018-2022.Frontiers in nephrology · 2026Article
- Article
- Long-term Clinical Outcomes after Endovascular Treatment by Aortoiliac Artery Stent Implantation.Journal of atherosclerosis and thrombosis · 2026Article
- Comparison of Diabetic Nephropathy Markers in Diabetic Patients With Insomnia Before and After Potassium and Magnesium Supplementation: A Randomized Controlled Trial.Health science reports · 2026Article
- The Physiological Roles and Pathological Implications of Urea Transporters in the Cardiovascular System.Biomedicines · 2025Review
- Machine learning-based prediction of atherosclerotic cardiovascular disease risk in adults with diabetes or prediabetes.BMC cardiovascular disorders · 2025Article
- Low-protein diet for chronic kidney disease: Evidence, controversies, and practical guidelines.Journal of internal medicine · 2025Review
- Development and validation of a predictive model for in-hospital mortality in patients with coronary heart disease and renal insufficiency.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Diagnosis and Emerging Biomarkers of Cystic Fibrosis-Related Kidney Disease (CFKD).Journal of clinical medicine · 2025Review
- Drug Exposure in Chronic Kidney Disease: It Is Not Just About the Glomerular Filtration Rate.Fundamental & clinical pharmacology · 2025Review
- Drivers and mechanisms of cognitive decline in chronic kidney disease.Nature reviews. Nephrology · 2025Review
- Atorvastatin Confers Renoprotection and Modulates Inflammation in Diabetic Rats on a High-Fat Diet.Life (Basel, Switzerland) · 2025Article
- Evaluation of neutrophil gelatinase-associated lipocalin (NGAL) levels as a biomarker for the early diagnosis of heart failure patients without of kidney disease.Journal of cardiovascular and thoracic research · 2025Article
- Homocitrulline Is Associated with Cardiovascular Outcomes in Nondialysis Patients with CKD.Kidney360 · 2025Article
- Associations between kidney function with all-cause and cause-specific mortality in type 2 diabetes mellitus patients: a prospective cohort study in China.Journal of health, population, and nutrition · 2025Article
Corrections and comments
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Authors and funding
15 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated serum urea levels are common in moderate-to-advanced CKD. Several studies have shown that urea is a direct and indirect uremic toxin, especially with regard to cardiovascular disease. We sought to determine whether serum urea levels are associated with adverse cardiovascular events and death before renal replacement therapy (RRT) in patients with CKD.
methodsCKD-REIN is a prospective cohort of CKD nephrology outpatients not receiving maintenance dialysis. The 2507 patients included in the analysis were divided into three groups according to the baseline serum urea level (T1 < 10.5, T2:10.5 to 15.1, and T3 ≥ 15.1 mmol/L). Cox proportional hazard models were used to estimate hazard ratios (HRs) for first atheromatous or nonatheromatous cardiovascular (CV) events, and all-cause mortality before RRT. The models were adjusted for baseline comorbidities, laboratory data, and medications.
findingsOf the 2507 included patients (median [interquartile range (IQR)] age: 69[61-77]; mean (standard deviation) eGFR 33.5(11.6) mL/min/1.73 m²), 54% had a history of cardiovascular disease. After multiple adjustments for cardiovascular risk factors (including eGFR), patients in T3 had a higher risk of atheromatous and nonatheromatous cardiovascular events than patient in T1 (n events = 451, HR[95%CI]: 1.93[1.39-2.69]). The adjusted HRs for death before RRT (n events = 407) were 1.31[0.97; 1.76] and 1.73[1.22; 2.45] for patients T2 and those in T3, respectively.
interpretationOur data suggested that urea is a predictor of cardiovascular outcomes beyond CV risk factors including eGFR.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.