Low High-Sensitivity C-Reactive Protein Level in Korean Patients With Chronic Kidney Disease and Its Predictive Significance for Cardiovascular Events, Mortality, and Adverse Kidney Outcomes: Results From KNOW-CKD
- Authors
- Lee, C.; Park, K.H.; Joo, Y.S.; Nam, K.H.; Chang, T.-I.; Kang, E.W.; Lee, J.; Oh, Y.K.; Jung, J.Y.; Ahn, C.; Lee, K.-B.; Park, J.T.; Yoo, T.-H.; Kang, S.-W.; Han, S.H.
- Issue Date
- Nov-2020
- Publisher
- WILEY
- Keywords
- cardiovascular events; chronic kidney disease; hs‐CRP; kidney outcome; mortality
- Citation
- Journal of the American Heart Association, v.9, no.21, pp.e017980
- Journal Title
- Journal of the American Heart Association
- Volume
- 9
- Number
- 21
- Start Page
- e017980
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/79064
- DOI
- 10.1161/JAHA.120.017980
- ISSN
- 2047-9980
- Abstract
- Background Inflammation levels are lower in East Asians than in Western people. We studied the association between high-sensitivity hs-CRP (C-reactive protein) and adverse outcomes in Korean patients with chronic kidney disease. Methods and Results We included 2018 participants from the KNOW-CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) between April 2011 and February 2016. The primary outcome was a composite of extended major cardiovascular events (eMACE) or all-cause mortality. The secondary end points were separate outcomes of eMACE, all-cause death, and adverse kidney outcome. We also evaluated predictive ability of hs-CRP for the primary outcome. The median hs-CRP level was 0.60 mg/L. During the mean follow-up of 3.9 years, there were 125 (6.2%) eMACEs and 80 (4.0%) deaths. In multivariable Cox analysis after adjustment of confounders, there was a graded association of hs-CRP with the primary outcome. The hazard ratios for hs-CRPs of 1.0 to 2.99 and ≥3.0 mg/L were 1.33 (95% CI, 0.87-2.03) and 2.08 (95% CI, 1.30-3.33) compared with the hs-CRP of <1.0 mg/L. In secondary outcomes, this association was consistent for eMACE and all-cause death; however, hs-CRP was not associated with adverse kidney outcomes. Finally, prediction models failed to show improvement of predictive performance of hs-CRP compared with conventional factors. Conclusions In Korean patients with chronic kidney disease, the hs-CRP level was low and significantly associated with higher risks of eMACEs and mortality. However, hs-CRP did not associate with adverse kidney outcome, and the predictive performance of hs-CRP was not strong. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT01630486.
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