Review Article

Heart-Kidney Interaction: Epidemiology of Cardiorenal Syndromes

Table 4

Summary of selected studies fulfilling criteria for Chronic Reno-Cardiac Syndrome (Type 4).

StudyPopulation (n)Study type (data source)CKD stageCardiac outcomes (%)Outcomes (%)

Herzog et al., 1998 [54]n = 34,189
Age ≥ 65 yrs 55%
Male 56%
Retrospective (USRDS)ESKDCardiac-Death: 1-yr 41%; 2-yr 52%; 5-yr 70.2%; 10-yr 83%All-cause: 1-yr 59%; 2-yr 73%; 5-yr 90%; 10-yr 97%
Muntner et al., 2002 [55]n = 6,534
Age 48–63 yrs
Male 51%–61%
Retrospective (NHANES II)eGFR < 70 75.9%CV-Death (rate per 1000 p-y): eGFR ≥ 90: 4.1; eGFR 70–89: 8.6; eGFR < 70: 20.5All-cause death (HR): eGFR ≥ 90: 1.00 eGFR 70–89: 1.64; eGFR < 70: 2.00
Go et al., 2004 [56]n = 1.1 million
Mean Age 52 yrs
Male 45%
Retrospective (Kaiser Permanente)≥ CKD stage III or eGFR < 60CV Event (rate per 100 p-y/HR): eGFR 45–59: 3.65/1.4; eGFR 30–44: 11.3/2.0; eGFR 15–29: 21.8/2.8; eGFR < 15: 36.6/3.4All-cause mortality (per 100 p-y/HR): eGFR 45–59: 1.1/1.2; eGFR 30–44: 4.8/1.8; eGFR 15–29: 11.4/3.2; eGFR < 15: 14.1/5.9
Foley et al., 2005 [3]n = 1,091,201
Age ≥ 75 yrs 56.1
Male 39%
Retrospective (Medicare/USRDS)CKD 3.8% (diagnostic coding)CV Event Incidence: AMI 4–7 per 100 p-y; CHF 31–52 per 100 p-y; (HR 1.28–1.79)All-cause death: HR 1.38–1.56
HIllege et al., 2006 [57]n = 2,680
Mean Age 65 yrs
Male 67%
Retrospective (CHARM)eGFR < 60 36%CV Death/Hosp. (HR) eGFR ≥ 90: 1.0; eGFR 75–89: 1.17; eGFR 60–74: 1.24; eGFR 45–59: 1.54 eGFR < 45: 1.86All-cause death (HR) eGFR ≥ 90: 1.0; eGFR 75–89: 1.13; eGFR 60–74: 1.14; eGFR 45–59: 1.50 eGFR < 45: 1.91
McCullough et al., 2007 [58]n = 37,153
Mean Age 53 yrs
Male 31%
Retrospective (KEEP)eGFR< 60 14.8%Prevalence CVD (OR): eGFR ≥ 90 1.0; eGFR 60–89 1.1; eGFR 30–59 1.4; eGFR < 30 1.3All-cause death (HR): CKD only 1.98; CVD only 3.02 CKD + CVD 3.80
McCullough et al., 2008 [59]n = 31,417
Mean Age 45 yrs
Male 24.5%
Retrospective (KEEP)eGFR< 60 or ACR ≥ 30: 20.6%Risk CVD/death (OR): CKD 1.44 No CKD 1.0Worst survival for combined CKD and CVD at time of screening

ESKD: end-stage kidney disease; CKD: chronic kidney disease; DM: diabetes mellitus; HTN: hypertension; CHF: congestive heart failure; CVD: cerebrovascular disease; MA: microalbuminuria: CHD: coronary heart disease; LVH: left ventricular hypertrophy; CV: cardiovascular; eGFR: estimated glomerular filtration rate; ADHF: acute decompensated heart failure.