Reduced kidney function correlates with increased sudden cardiac death risk
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In the general population in the Netherlands, reduced kidney function is linked with increased risk of sudden cardiac death, according to data published in the Clinical Kidney Journal.
Further, eGFR based on cystatin C levels (eGFRcys) could be added to prediction models for sudden cardiac death (SCD) prevention.
“In patients with chronic kidney disease, SCD accounts for 16% of mortality and several studies have suggested an increased risk of SCD in patients with reduced kidney function. However, it is still largely unknown whether kidney function is also associated with SCD in the general population,” Anna C. van der Burgh, BSc, from the department of internal medicine at Erasmus Medical Center at the University Medical Center Rotterdam in the Netherlands, and colleagues wrote. They added, “Hence, we aimed to investigate the association between kidney function, defined by eGFR based on serum creatinine and/or cystatin C levels, and the risk of SCD in middle-aged and elderly individuals participating in a prospective population-based cohort study.”
Researchers evaluated 9,687 participants (mean age was 65.3 years; 56.7% were women) from the prospective population-based Rotterdam study that took place between 1997 and 2014 in the Netherlands.
Using Cox proportional-hazards and joint models, researchers explored the relationship between kidney function assessments, such as eGFR based on serum creatinine (eGFRcreat), eGFRcys or both (eGFRcreat-cys), and SCD. Researchers utilized competing risk analyses to calculate absolute 10-year risks, and then followed up at the median time of 8.9 years.
During the study, 2,764 participants died including 808 participants whose deaths were attributed to cardiovascular- and cerebrovascular-related events. Overall, researchers recorded 243 SCD events during follow-up with an incidence rate of 2.6 per 1,000 person-years.
Analyses revealed lower eGFRcys and eGFRcreat-cys correlated with an increased risk of SCD. Similarly, an eGFRcys of 90 mL/min per 1.73 m² compared with 60 mL/min per 1.73 m² showed the absolute 10-year risks increased from 1% to 2.5%.
Researchers identified subgroups such as older participants and participants with atrial fibrillation to be at increased risk, regardless of coronary heart disease, hypertension or diabetes.
“Our findings could be clinically relevant, as they open up new avenues for future research. This includes further investigation of the pathophysiological mechanisms underlying the association between kidney function and SCD,” van der Burgh and colleagues wrote. They added, “In addition, future research should determine whether eGFRcys can be utilized in screening programs in the general population for underlying but yet undiagnosed CVD.”
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