Medication Use and Heart Risks in Kidney Disease
Author Information
Author(s): Nisha Bansal, Chi-yuan Hsu, Malini Chandra, Carlos Iribarren, Stephen P. Fortmann, Mark A. Hlatky, Alan S. Go
Primary Institution: University of California, San Francisco
Hypothesis
Does differential cardiovascular drug use explain the excess risk of cardiovascular events and death in patients with chronic kidney disease (CKD) and coronary heart disease (CHD)?
Conclusion
Differential use of cardiovascular medications may contribute to the higher risk of cardiovascular events and death in patients with CKD.
Supporting Evidence
- Patients with CKD had a higher incidence of cardiovascular events compared to those without CKD.
- ACE inhibitor use was lower in CKD patients post-CHD event.
- Calcium channel blocker use was higher in CKD patients compared to non-CKD patients.
Takeaway
People with kidney disease are at a higher risk of heart problems, and not getting the right heart medications might make it worse.
Methodology
The study followed patients with new onset coronary heart disease, comparing those with and without chronic kidney disease over several years.
Potential Biases
Potential confounding by indication for selected medications.
Limitations
The study could not account for all potential confounding factors and was conducted within a specific healthcare system, limiting generalizability.
Participant Demographics
Patients aged 45 to 75 years, with a mix of genders and a higher proportion of women in the CKD group.
Statistical Information
P-Value
0.03
Confidence Interval
95% CI: 1.10 to 2.02 for eGFR 45-59 ml/min/1.73 m2; 95% CI: 1.00 to 2.50 for eGFR < 45 ml/min/1.73 m2
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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