Article Text

The impact of chronic kidney disease and cardiovascular comorbidity on mortality in a multiethnic population: a retrospective cohort study
  1. Mark Jesky1,2,
  2. Amanda Lambert3,
  3. A C Felix Burden4,
  4. Paul Cockwell1,2
  1. 1Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  2. 2Division of Infection and Immunity, University of Birmingham, Birmingham, UK
  3. 3Public Health Intelligence, Birmingham City Council, Birmingham, UK
  4. 4Sandwell and West Birmingham Clinical Commissioning Group, Birmingham, UK
  1. Correspondence to Mark Jesky; mark.jesky{at}uhb.nhs.uk

Abstract

Objective To assess the impact of chronic kidney disease (CKD) and cardiovascular comorbidity on mortality in a multiethnic primary care population.

Design Retrospective cohort study.

Setting Inner-city primary care trust in West Midlands, UK.

Participants Individuals aged 40 years and older, of South Asian, black or white ethnicity, registered with a general practice and with their kidney function checked within the last 12 months (n=31 254).

Outcome measure All-cause mortality.

Results Reduced estimated glomerular filtration rate, higher albuminuria, older age, white ethnicity (vs South Asian or black ethnicity) and increasing cardiovascular comorbidities were independent determinants of a higher mortality risk. In the multivariate model including comorbidities and kidney function, the HR for mortality for South Asians was 0.697 (95% CI 0.56 to 0.868, p=0.001) and for blacks it was 0.533 (95% CI 0.403 to 0.704, p<0.001) compared to whites.

Conclusions The HR for death is lower for South Asian and black individuals compared to white individuals. This is, in part, independent of age, gender, socioeconomic status, kidney function and comorbidities. Risk of death is higher in individuals with CKD and with a higher cumulative cardiovascular comorbidity.

  • EPIDEMIOLOGY
  • PRIMARY CARE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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