KS TAN1,2,3, S NG3, J ZHANG1,2, Z WANG1,2, A CAMERON1,2, WE HOY1,2
1NHMRC CKD.CRE and CKD.QLD, Brisbane, Queensland; 2Faculty of Medicine, University of Queensland, Brisbane, Queensland; 3Renal unit, Logan Hospital & Metro South Health Service, Brisbane, Queensland.
AIMS: Determine the type of first Cardiovascular (CVS) event in patients with diabetes mellitus (DM) enrolled in the CKD.QLD registry who had undergone renal biopsy.
BACKGROUND: The CKD.QLD registry is a Queensland-wide registry of patients with chronic kidney disease (CKD) who are followed up in the state’s public hospital renal units and have provided informed consent. Enrolment commenced in 2011.
METHODS: Patients with DM enrolled in the registry between 22/01/2011 and 15/11/2016 inclusive with previous renal biopsy were included. Baseline characteristics, incidence and nature of the first CVS event post enrolment were determined. Censor date was 1/03/2017.
RESULTS: Among 2665 CKD patients with DM, 189 patients (84 women) had undergone renal biopsy. Mean follow up at censor date was 3.1 years. Mean age at enrolment was 60.2y (SD 12.5). 57 patients (30%) had known CVS disease at enrolment.
At censor date, 52 patients had experienced at least one CVS event. The commonest first CVS event which occurred in 35 patients (67%) was cardiac (acute coronary syndrome/coronary revascularization procedure/admission for acute heart failure). 37% of those who suffered a CVS event had at least one prior CVS event at time of enrolment compared to 28% of those who did not suffer a CVS event although this difference was not statistically significant (p= 0.24).
At censor date, 14 of these 52 patients (27%) had died without commencing renal replacement therapy (RRT) although three (6%) were already committed to supportive care. Eight patients (15%) had commenced RRT.
CONCLUSIONS: In this group of patients at high risk of CVS events, the commonest type of CVS event was cardiac. Known underlying CVS disease did not obviously increase risk.