Impact of Chronic Kidney Disease on Aortic Disease-related Mortality: A Four-year Community-Based Cohort Study

Yoichiro Otaki; Tetsu Watanabe; Tsuneo Konta; Masafumi Watanabe; Koichi Asahi; Kunihiro Yamagata; Shouichi Fujimoto; Kazuhiko Tsuruya; Ichiei Narita; Masato Kasahara; Yugo Shibagaki; Kunitoshi Iseki; Toshiki Moriyama; Masahide Kondo; Tsuyoshi Watanabe

doi:10.2169/internalmedicine.5798-20

ORIGINAL ARTICLES

Impact of Chronic Kidney Disease on Aortic Disease-related Mortality: A Four-year Community-Based Cohort Study

Yoichiro Otaki, Tetsu Watanabe, Tsuneo Konta, Masafumi Watanabe, Koichi Asahi, Kunihiro Yamagata, Shouichi Fujimoto, Kazuhiko Tsuruya, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Kunitoshi Iseki, Toshiki Moriyama, Masahide Kondo, Tsuyoshi Watanabe

Author information

Yoichiro Otaki
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan
Tetsu Watanabe
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan
Tsuneo Konta
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan
Masafumi Watanabe
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Japan
Koichi Asahi
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Kunihiro Yamagata
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Shouichi Fujimoto
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Kazuhiko Tsuruya
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Ichiei Narita
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Masato Kasahara
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Yugo Shibagaki
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Kunitoshi Iseki
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Toshiki Moriyama
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Masahide Kondo
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan
Tsuyoshi Watanabe
Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check, Japan

Keywords: chronic kidney disease, aortic disease, general population

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 5 Pages 689-697

DOI https://doi.org/10.2169/internalmedicine.5798-20

Details

Abstract

Objective Despite advances in medicine, aortic diseases (ADs), such as aneurysm rupture and aortic dissection, remain fatal and carry extremely high mortality rates. Due to its low frequency, the risk of developing AD has not yet been fully elucidated. Chronic kidney disease (CKD) is an established risk factor for cardiovascular disease and mortality. The aim of the present study was to examine whether or not CKD is a risk for AD-related mortality in the general population.

Methods We used a nationwide database of 554,442 subjects (40-75 years old) who participated in the annual "Specific Health Check and Guidance in Japan" checkup between 2008 and 2013.

Results There were 131 aortic aneurysm and dissection deaths during the follow-up period of 2,123,512 person-years. A Kaplan-Meier analysis revealed that subjects with CKD had a higher rate of AD-related deaths than those without it. A multivariate Cox proportional hazard regression analysis demonstrated that CKD was an independent risk factor for AD-related death in the general population after adjusting for cardiovascular risk factors. The addition of CKD to cardiovascular risk factors significantly improved the C, net reclassification, and integrated discrimination indexes.

Conclusion CKD is an additional risk for AD-related death, suggesting that CKD may be a target for the prevention and early identification of subjects at high risk for AD-related death in the general population.

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