ArticleKidney diseases (Basel, Switzerland)
Risk Factors for All-Cause and Cause-Specific Mortality in Patients with Chronic Kidney Disease: Age-Specific Associations and Attributable Burden.
Article in Kidney diseases (Basel, Switzerland). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Evidence regarding age-specific associations between risk factors and mortality in patients with chronic kidney disease (CKD) remains limited. We sought to investigate these age-specific associations and to measure their attributable burden on mortality. Methods: This population-based, retrospective cohort study included 576,677 patients in Hong Kong (73.5 ± 13.8 years, 2008-2020). We assessed all-cause and seven cause-specific mortality. Risk factors included six modifiable risk factors (smoking, blood pressure, fasting blood glucose/hemoglobin A1c, low-density lipoprotein cholesterol [LDL-C], and body mass index) and four major comorbidities (diabetes, cardiovascular disease [CVD], heart failure, and cancer). Using hazard ratios and population-attributable fractions (PAFs), we compared the associations and mortality burden of these risk factors across five age-groups (18 to ≥85 years). Results: During a median follow-up of 4.8 years, 329,098 (57.1%) patients died, with primary death causes being CVD (9.9%), cancer (9.9%), and kidney diseases (4.7%). Despite a higher absolute mortality risk in older patients, the relative risk of most risk factors declined with age. Collectively, all risk factors accounted for a higher mortality proportion in the youngest group (PAF: 44.3% [95% confidence interval: 35.3%, 52.0%]) than in the oldest group (22.6% [14.6%, 29.7%]). For patients aged 18-54, suboptimal LDL-C control (12.0% [8.0%, 15.8%]) was the leading risk factor, while CVD (12.6% [12.1%, 13.1%]) was the most influential factor in patients aged ≥75. Conclusion: The evaluated risk factors were associated with increased relative mortality risks in younger CKD patients. These findings underscore the importance of early management strategies, emphasizing LDL-C control in younger and CVD prevention in older CKD patients.
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