Kidney function predicts new-onset cardiorenal events and mortality in primary aldosteronism: approach of the 2021 race-free eGFR equation

• Published in: Hypertension research 2024-01, Vol.47 (1), p.233-244
• Main Authors: Lai, Chun-Fu, Lin, Yen-Hung, Huang, Kuo-How, Chueh, Jeff S, Wu, Vin-Cent
• Format: Article
• Language: English
• Subjects: Adult; Female; Glomerular Filtration Rate; Humans; Hyperaldosteronism - complications; Kidney; Male; Middle Aged; Myocardial Infarction - complications; Renal Insufficiency, Chronic - complications
• ISSN: 0916-9636; 1348-4214; 1348-4214
• DOI: 10.1038/s41440-023-01400-0

Individuals with primary aldosteronism (PA) exhibit glomerular hyperfiltration, which may conceal underlying kidney damage. This observational cohort study enrolled 760 coronary artery disease-naive patients diagnosed with PA between January 1, 2007 and December 31, 2018 (male, 45%; mean age, 52.3 ± 11.9 years). The baseline estimated glomerular filtration rate (eGFR) was calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which includes serum creatinine and cystatin C but omits the race variable. During a mean follow-up of 5.8 ± 3.2 years, new-onset composite cardiovascular events (total death, non-fatal myocardial infarction, and coronary revascularization procedure) occurred at a crude incidence rate of 10.9 per 1,000 person-years. Multivariable Cox proportional hazards analysis showed that baseline eGFR was independently associated with composite cardiovascular events (hazard ratio [HR], 0.98 [95% CI, 0.97-0.99]). Penalized splines smoothing in multivariable regression analysis demonstrated that the risk of composite cardiovascular events increased negatively and linearly when patients had a baseline eGFR less than 85 mL/min/1.73 m . Patients with baseline eGFR