Interactive exploration of adverse events and multimorbidity in CKD
Creators: name: Steinbrenner, Inga
name: Kotsis, Fruzsina
name: Kosch, Robin
name: Meiselbach, Heike
name: Bärthlein, Barbara
name: Stockmann, Helena
name: Lipovsek, Jan
name: Zacharias, Helena U.
name: Altenbuchinger, Michael
name: Dienemann, Thomas
name: Wytopil, Monika
name: Bächle, Helena
name: Sommerer, Claudia
name: Titze, Stephanie
name: Weigel, Anke
name: Weissensteiner, Hansi
name: Schönherr, Sebastian
name: Forer, Lukas
name: Kurz, Nadine S.
name: Menne, Jan
name: Schlieper, Georg
name: Schneider, Markus P.
name: Schaeffner, Elke
name: Kielstein, Jan T.
name: Sitter, Thomas
name: Floege, Jürgen
name: Wanner, Christoph
name: Kronenberg, Florian
name: Köttgen, Anna
name: Busch, Martin
name: Krane, Vera
name: Schmid, Matthias
name: Eckardt, Kai-Uwe
name: Schultheiss, Ulla T.
name: Eckardt, Kai-Uwe
name: Meiselbach, Heike
name: Schneider, Markus P.
name: Schiffer, Mario
name: Prokosch, Hans-Ulrich
name: Bärthlein, Barbara
name: Beck, Andreas
name: Reis, André
name: Ekici, Arif B.
name: Becker, Susanne
name: Alberth-Schmidt, Ulrike
name: Weigel, Anke
name: Marschall, Sabine
name: Schefler, Eugenia
name: Walz, Gerd
name: Köttgen, Anna
name: Schultheiß, Ulla T.
name: Kotsis, Fruzsina
name: Meder, Simone
name: Mitsch, Erna
name: Reinhard, Ursula
name: Floege, Jürgen
name: Saritas, Turgay
name: Groß, Alice
name: Schaeffner, Elke
name: Baid-Agrawal, Seema
name: Theisen, Kerstin
name: Schmidt-Ott, Kai
name: Zeier, Martin
name: Sommerer, Claudia
name: Aykac, Mehtap
name: Wolf, Gunter
name: Busch, Martin
name: Steiner, Andy
name: Sitter, Thomas
name: Wanner, Christoph
name: Krane, Vera
name: Börner-Klein, Antje
name: Bauer, Britta
name: Kronenberg, Florian
name: Raschenberger, Julia
name: Kollerits, Barbara
name: Forer, Lukas
name: Schönherr, Sebastian
name: Weissensteiner, Hansi
name: Oefner, Peter J.
name: Gronwald, Wolfram
name: Schmid, Matthias
name: Nadal, Jennifer
Publisher: name: Universität Regensburg
Year: 2024
Subjects: subject: adverse events; chronic kidney disease; epidemiology; interactive visualization; multimorbidity; kidney failure, chronic cardiovascular system infections kidney mortality adverse event multimorbidity
subject: 610 Medizin

description: Background: Persons with chronic kidney disease (CKD) are at increased risk of adverse events, early mortality and multimorbidity. A detailed overview of adverse event types and rates from a large CKD cohort under regular nephrological care is missing. We generated an interactive tool to enable exploration of adverse events and their combinations in the prospective, observational German CKD (GCKD) study.

Methods: The GCKD study enrolled 5217 participants under regular nephrological care with an estimated glomerular filtration rate of 30-60 or &gt;60 mL/min/1.73 m2 and an overt proteinuria. Cardiovascular, cerebrovascular and peripheral vascular, kidney, infection, and cancer events, as well as deaths were adjudicated following a standard operation procedure. We summarized these time-to-event data points for exploration in interactive graphs within an R shiny app. Multivariable adjusted Cox models for time to first event were fitted. Cumulative incidence functions, Kaplan-Meier curves and intersection plots were used to display main adverse events and their combinations by sex and CKD etiology.

Results: Over a median of 6.5 years, 10 271 events occurred in 2947 participants (56.5%), of which 680 participants (13.0%) died. The new publicly available interactive platform enables readers to scrutinize adverse events and their combinations as well as mortality trends as a gateway to better understand multimorbidity in CKD: incident rates per 1000 patient-years varied by event type, CKD etiology and baseline characteristics. Incidence rates for the most frequent events and their recurrence were 113.6 (cardiovascular), 75.0 (kidney) and 66.0 (infection). Participants with presumed diabetic kidney disease and men were more prone to experiencing events.

Conclusion: This comprehensive explorative tool to visualize adverse events (https://www.gckd.org/studienhintergrund/previous-study-results/event-analysis/), their combination, mortality and multimorbidity among persons with CKD may serve as a valuable resourec for patient care, identification of high-risk groups, health services and public health policy planning.