Table 3

Risks of all-cause mortality, major adverse cardiovascular events and adverse renal outcomes among patients with CKD with diastolic dysfunction

OutcomeNo. of eventsPerson-yearsIncidence rate*Before IPTWIPTWIPTW-adjusted†
HR (95% CI)P valueHR (95% CI)P valueHR (95% CI)P value
All-cause mortality
 Grade 1 diastolic dysfunction14820657.174.02 (3.30 to 4.89)<0.0012.29 (1.78 to 2.94)<0.0011.94 (1.51 to 2.49)<0.001
 Grade 2 diastolic dysfunction17732915.383.17 (2.63 to 3.81)<0.0011.92 (1.47 to 2.50)<0.0012.24 (1.72 to 2.94)<0.001
 Grade 3 diastolic dysfunction283997.024.12 (2.80 to 6.07)<0.0012.71 (1.56 to 4.70)<0.0013.33 (1.92 to 5.77)<0.001
 Non-HF31119 8021.57ReferenceReference
Major adverse cardiovascular events
 Grade 1 diastolic dysfunction193168811.433.36 (2.85 to 3.97)<0.0012.23 (1.75 to 2.83)<0.0011.96 (1.53 to 2.51)<0.001
 Grade 2 diastolic dysfunction290266810.873.47 (3.00 to 4.01)<0.0012.60 (2.13 to 3.18)<0.0012.75 (2.27 to 3.34)<0.001
 Grade 3 diastolic dysfunction4729415.994.93 (3.65 to 6.64)<0.0013.11 (1.98 to 4.88)<0.0013.21 (2.07 to 4.98)<0.001
 Non-HF51018 4762.76ReferenceReferenceReference
Ischaemic stroke
 Grade 1 diastolic dysfunction3419961.701.37 (0.95 to 1.97)0.0900.98 (0.60 to 1.60)0.9390.80 (0.50 to 1.30)0.375
 Grade 2 diastolic dysfunction4531691.421.18 (0.86 to 1.63)0.3130.77 (0.50 to 1.18)0.2290.82 (0.54 to 1.23)0.331
 Grade 3 diastolic dysfunction53941.271.06 (0.44 to 2.57)0.9010.93 (0.32 to 2.69)0.8991.08 (0.38 to 3.05)0.889
 Non-HF21819 2041.14ReferenceReferenceReference
Myocardial infarction
 Grade 1 diastolic dysfunction3020151.493.14 (2.05 to 4.80)<0.0011.80 (1.12 to 2.88)0.0151.51 (0.93 to 2.46)0.096
 Grade 2 diastolic dysfunction4831921.503.42 (2.38 to 4.92)<0.0012.61 (1.55 to 4.37)<0.0012.25 (1.36 to 3.73)0.002
 Grade 3 diastolic dysfunction83862.074.66 (2.25 to 9.65)<0.0013.92 (1.63 to 9.41)0.0023.29 (1.37 to 7.91)0.008
 Non-HF7619 6090.39ReferenceReferenceReference
Hospitalisation for HF
 Grade 1 diastolic dysfunction15517698.764.91 (4.02 to 5.99)<0.0013.03 (2.28 to 4.03)<0.0012.73 (2.03 to 3.67)<0.001
 Grade 2 diastolic dysfunction23028268.144.98 (4.17 to 5.94)<0.0013.70 (2.92 to 4.68)<0.0014.02 (3.21 to 5.03)<0.001
 Grade 3 diastolic dysfunction4230713.688.00 (5.78 to 11.08)<0.0014.62 (2.87 to 7.43)<0.0014.74 (2.94 to 7.65)<0.001
 Non-HF27319 1571.43ReferenceReferenceReference
Estimated glomerular filtration rate decline >30%
 Grade 1 diastolic dysfunction5319642.702.30 (1.68 to 3.14)<0.0011.79 (1.09 to 2.93)0.0211.54 (0.92 to 2.58)0.097
 Grade 2 diastolic dysfunction6531282.082.05 (1.53 to 2.74)<0.0011.45 (0.97 to 2.17)0.0711.48 (0.99 to 2.20)0.055
 Grade 3 diastolic dysfunction133603.613.37 (1.91 to 5.95)<0.0013.29 (1.60 to 6.77)0.0013.22 (1.57 to 6.63)0.001
 Non-HF15219 2760.79ReferenceReferenceReference
End-stage renal disease†
 Grade 1 diastolic dysfunction9019174.693.18 (2.47 to 4.09)<0.0012.01 (1.39 to 2.90)<0.0011.61 (1.14 to 2.28)0.007
 Grade 2 diastolic dysfunction13830184.573.58 (2.87 to 4.46)<0.0012.18 (1.63 to 2.91)<0.0011.99 (1.48 to 2.67)<0.001
 Grade 3 diastolic dysfunction203745.354.17 (2.63 to 6.61)<0.0012.59 (1.33 to 5.03)0.0052.76 (1.40 to 5.43)0.003
 Non-HF19119 2680.99ReferenceReferenceReference
  • *Per 102 person-years.

  • †Adjusted for age, sex, haemoglobin A1c, estimated glomerular filtration rate, spot urine protein-to-creatinine ratio, spot urine albumin-to-creatinine ratio, hypertension, diabetes mellitus, coronary artery disease, malignancy, uses of calcium channel blockers, beta-blockers, renin-angiotensin-aldosterone system inhibitors, statins, oral hypoglycaemic agents and insulin.

  • CKD, chronic kidney disease; HF, heart failure; IPTW, inverse probability of treatment weighting.