Managing cardiovascular risk factors in patients with chronic kidney disease: Pharmacological and non-pharmacological interventions in the Copenhagen CKD Cohort
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Managing cardiovascular risk factors in patients with chronic kidney disease : Pharmacological and non-pharmacological interventions in the Copenhagen CKD Cohort. / Freese Ballegaard, Ellen Linnea; Carlson, Nicholas; Buus Jørgensen, Morten; Sørensen, Ida Maria Hjelm; Trankjær, Helene; Almarsdóttir, Anna Birna; Bro, Susanne; Feldt-Rasmussen, Bo; Kamper, Anne Lise; for The Copenhagen CKD Cohort Study Group.
In: Clinical Kidney Journal, Vol. 17, No. 7, sfae158, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Managing cardiovascular risk factors in patients with chronic kidney disease
T2 - Pharmacological and non-pharmacological interventions in the Copenhagen CKD Cohort
AU - Freese Ballegaard, Ellen Linnea
AU - Carlson, Nicholas
AU - Buus Jørgensen, Morten
AU - Sørensen, Ida Maria Hjelm
AU - Trankjær, Helene
AU - Almarsdóttir, Anna Birna
AU - Bro, Susanne
AU - Feldt-Rasmussen, Bo
AU - Kamper, Anne Lise
AU - for The Copenhagen CKD Cohort Study Group
N1 - Publisher Copyright: © 2024 The Author(s).
PY - 2024
Y1 - 2024
N2 - Background: Although cardiovascular morbidity and mortality are substantial in patients with chronic kidney disease (CKD), guideline-directed treatment of cardiovascular risk factors remains a challenge. Methods: Observational, cross-sectional study including patients aged 30-75 years with CKD stage 1-5 without kidney replacement therapy from a tertiary hospital outpatient clinic. Data were obtained through patient interview, clinical examination, biochemical work-up, and evaluation of medical records and prescription redemptions. Guideline-directed treatment was evaluated as pharmacological interventions: Antihypertensive and lipid-lowering therapy including adverse effects and adherence estimated as medication possession ratio (MPR); and non-pharmacological interventions: smoking status, alcohol consumption, body mass index (BMI), and physical activity. Results: The cohort comprised 741 patients, mean age 58 years, 61.4% male, 50.6% CKD stage 3, 61.0% office blood pressure ≤140/90 mmHg. Antihypertensives were prescribed to 87.0%, median number of medications 2 (IQR 1;3), 70.1% received renin-Angiotensin system inhibition, 25.9% reported adverse effects. Non-Adherence (MPR < 80%) was present in 23.4% and associated with elevated blood pressure (OR 1.53 (95% CI 1.03;2.27)) and increased urinary albumin excretion, P < 0.001. Lipid-lowering treatment was prescribed to 54.0% of eligible patients, 11.1% reported adverse effects, and 28.5% were non-Adherent, which was associated with higher LDL cholesterol, P = 0.036. Overall, 19.2% were current smokers, 16.7% overconsumed alcohol according to Danish health authority recommendations 69.3% had BMI ≥ 25 kg/m2, and 38.3% were physically active <4 hours/week. Among patients prescribed antihypertensives, 51.9% reported having received advice on non-pharmacological interventions. Conclusions: Improved management of cardiovascular risk in patients with CKD entails intensified medical treatment and increased focus on patient adherence and non-pharmacological interventions.
AB - Background: Although cardiovascular morbidity and mortality are substantial in patients with chronic kidney disease (CKD), guideline-directed treatment of cardiovascular risk factors remains a challenge. Methods: Observational, cross-sectional study including patients aged 30-75 years with CKD stage 1-5 without kidney replacement therapy from a tertiary hospital outpatient clinic. Data were obtained through patient interview, clinical examination, biochemical work-up, and evaluation of medical records and prescription redemptions. Guideline-directed treatment was evaluated as pharmacological interventions: Antihypertensive and lipid-lowering therapy including adverse effects and adherence estimated as medication possession ratio (MPR); and non-pharmacological interventions: smoking status, alcohol consumption, body mass index (BMI), and physical activity. Results: The cohort comprised 741 patients, mean age 58 years, 61.4% male, 50.6% CKD stage 3, 61.0% office blood pressure ≤140/90 mmHg. Antihypertensives were prescribed to 87.0%, median number of medications 2 (IQR 1;3), 70.1% received renin-Angiotensin system inhibition, 25.9% reported adverse effects. Non-Adherence (MPR < 80%) was present in 23.4% and associated with elevated blood pressure (OR 1.53 (95% CI 1.03;2.27)) and increased urinary albumin excretion, P < 0.001. Lipid-lowering treatment was prescribed to 54.0% of eligible patients, 11.1% reported adverse effects, and 28.5% were non-Adherent, which was associated with higher LDL cholesterol, P = 0.036. Overall, 19.2% were current smokers, 16.7% overconsumed alcohol according to Danish health authority recommendations 69.3% had BMI ≥ 25 kg/m2, and 38.3% were physically active <4 hours/week. Among patients prescribed antihypertensives, 51.9% reported having received advice on non-pharmacological interventions. Conclusions: Improved management of cardiovascular risk in patients with CKD entails intensified medical treatment and increased focus on patient adherence and non-pharmacological interventions.
KW - adherence
KW - blood pressure
KW - cardiovascular
KW - chronic kidney disease
KW - dyslipidemia
U2 - 10.1093/ckj/sfae158
DO - 10.1093/ckj/sfae158
M3 - Journal article
C2 - 38979108
AN - SCOPUS:85198664988
VL - 17
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
SN - 2048-8505
IS - 7
M1 - sfae158
ER -
ID: 399106347