#3466 RISK FACTORS AND TRANSITIONAL PROBABILITY OF CLINICAL EVENTS IN KOREAN CKD PATIENTS USING THE MULTI-STATE MODEL: RESULTS FROM THE KNOW-CKD STUDY

Abstract

Abstract Background and Aims Compared to western countries, Korean CKD patients show distinctive differences in clinical outcomes including lower cardiovascular disease (CVD) and higher end-stage kidney disease (ESKD) events. This study analysed the risk factors, transition probability and cumulative hazards associated with clinical events using the multi-state model. Method This study included 1423 patients at CKD stages 1-4 from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease. Multivariate multi-state model analysis was performed to investigate the risk factors, 10-year transition rate and cumulative hazard estimates for five clinical event status including ESKD, CVD, death, death after ESKD and death after CVD events. Results Among 1423 patients (age 54 [44-63] years), the overall prevalence of clinical events were the following: ESKD (22.6%), CVD (7.5%), death (3.3%), death after ESKD (3.6%) and death after CVD (1.2%). Different risk factors were associated with different clinical outcomes and in particular the risk factors associated with higher ESKD event were underlying CVD, diabetes, polycystic kidney disease, fibroblast growth factor-23 while hypertension, increased age and estimated glomerular filtration rates were associated with lower risks. The 10-year progression probability for each event status include the following: 0.23 for ESKD, 0.08 for CVD, 0.04 for death, 0.09 for death after ESKD and 0.01 for death after CVD (Figure 1). The 10-year cumulative hazard estimates for each event status were the following: ESKD [0.43, 95% CI (0.37-0.49)], CVD [0.12, (0.10-0.15)], death [0.05, (0.03-0.06)], death after ESKD [0.52, (0.20-0.84)] and death after CVD [0.27, (0.15-0.40)] (Figure 2). Conclusion Different risk factors were associated with varying clinical outcomes in Korean CKD patients. The 10-year progression probability was the highest in ESKD followed by death after ESKD events. Also, the 10-year cumulative hazard estimate was the highest for death after ESKD followed by ESKD events. These findings correlate with the distinctive clinical outcome features of Korean CKD patients.