Dysglycemia Predicts Cardiovascular and Kidney Disease in the Kidney Early Evaluation Program

Abstract

The cardiometabolic syndrome has been associated with both chronic kidney disease (CKD) and cardiovascular disease (CVD). Using data from the National Kidney Foundation-Kidney Early Evaluation Program, the authors sought to investigate this association in a targeted CKD cohort. A total of 26,992 patients met eligibility criteria including age 18 years and older, diabetes, hypertension, or family history of CKD, diabetes, or hypertension and excluded those taking renal replacement therapy. Individuals were identified by Third Report of the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) criteria (dysglycemia, hypertension, and dyslipidemia) and World Health Organization criteria (obesity and proteinuria). Univariate and multivariate analyses were used to evaluate increasing components of the cardiometabolic syndrome, CKD, and CVD. On multivariate analysis there was a graded relationship between increasing components with an increased prevalence of CKD and CVD. Additionally, there was a graded trend with the stage of dysglycemia (eg, normoglycemia, prediabetes, and overt diabetes) and increasing CKD. However, there was only an increased prevalence of CVD observed in the clinically diabetic group. This trend was also observed with increasing serum glucose levels and an increasing percent of CVD and CKD up to 160 mg/dL. However, prevalent CVD increased at >140 mg/dL and prevalent CKD at >180 mg/dL. Therefore, data support that increasing metabolic components and dysglycemia are strongly associated with an increased prevalence of CKD and CVD.