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Table 5 Association of the Fibrosis-4 score on CVE, ESRD and all-cause mortality for individuals with CKD and NAFLD

From: The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank

  

Participants

Events

Median follow-up (months)

Event rate

Univariate model

Multivariable model 1

Multivariable model 2

Multivariable model 3

All cardiovascular events, HR (95% CI)

Low risk

7202

1887

160.4

0.014

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

949

156.9

0.017

1.28 (1.16–1.41)****

1.14 (1.03–1.26)*

1.11 (1.00–1.23)*

1.13 (1.02–1.25)*

High risk

308

153

145.3

0.027

1.64 (1.30–2.08)****

1.17 (0.92–1.48)

1.09 (0.85–1.39)

1.07 (0.84–1.36)

Acute coronary syndrome, HR (95% CI)

Low risk

7202

659

163.4

0.005

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

314

160.1

0.005

1.20 (1.01–1.42)*

1.05 (0.88–1.24)

1.01 (0.85–1.20)

1.03 (0.86–1.22)

High risk

308

47

154.3

0.007

1.36 (0.90–2.05)

0.95 (0.63–1.45)

0.941.46 (0.6293–1.442.30)

0.94 (0.62–1.43)

Heart failure, HR (95% CI)

Low risk

7202

1025

163.5

0.007

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

512

160.6

0.008

1.25 (1.09–1.42)***

1.12 (0.98–1.28)

1.08 (0.95–1.24)

1.11 (0.97–1.27)

High risk

308

101

153.8

0.014

1.86 (1.39–2.47)****

1.32 (0.99–1.75)

1.25 (0.93–1.66)

1.25 (0.94–1.67)

Cerebrovascular accident, HR (95% CI)

Low risk

7202

683

163.6

0.005

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

367

160.5

0.006

1.18 (1.00–1.39)

1.07 (0.90–1.26)

1.06 (0.89–1.26)

1.08 (0.91–1.28)

High risk

308

63

154.6

0.008

1.77 (1.24–2.53)**

1.26 (0.87–1.82)

1.19 (0.81–1.74)

1.18 (0.81–1.73)

Peripheral arterial disease, HR (95% CI)

Low risk

7202

414

164.2

0.003

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

195

161.4

0.003

1.24 (1.00–1.53)*

1.08 (0.87–1.33)

1.06 (0.85–1.31)

1.08 (0.87–1.35)

High risk

308

41

155.8

0.005

1.61 (1.00–2.59)

1.11 (0.68–1.79)

1.01 (0.62–1.64)

1.05 (0.65–1.70)

End-stage renal disease, HR (95% CI)

Low risk

7202

225

164.5

0.001

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

139

156.9

0.002

1.39 (1.06–1.83)*

1.25 (0.94–1.65)

0.94 (0.70–1.28)

0.97 (0.72–1.31)

High risk

308

20

145.3

0.002

1.51 (0.77–2.96)

1.31 (0.67–2.59)

0.73 (0.36–1.46)

0.95 (0.48–1.91)

All-cause mortality, HR (95% CI)

Low risk

7202

2033

164.7

0.013

1.00 ref

1.00 ref

1.00 ref

1.00 ref

Intermediate risk

2642

935

156.9

0.013

1.10 (0.99–1.21)

1.00 (0.90–1.10)

0.94 (0.85–1.05)

0.96 (0.87–1.07)

High risk

308

227

145.3

0.028

1.82 (1.47–2.24)****

1.27 (1.03–1.57)****

1.16 (0.93–1.44)

1.17 (0.94–1.45)

  1. Model 1: adjusted for age, sex, deprivation and ethnicity
  2. Model 2: adjusted for age, sex, deprivation, ethnicity, smoking and baseline eGFR and UACR
  3. Model 3: adjusted for age, sex, deprivation, ethnicity, smoking, baseline eGFR and UACR and diabetes
  4. Low-risk fibrosis: Fibrosis-4 score < 1.3 (< 2.0 if ≥ 65 years)
  5. Intermediate risk fibrosis: Fibrosis-4 score 1.3–2.67 (2.0–2.67 if ≥ 65 years)
  6. High-risk fibrosis: Fibrosis-4 score > 2.67
  7. HR hazard ratio, CI confidence interval
  8. *p < 0.05
  9. **p < 0.01
  10. ***p < 0.001
  11. ****p < 0.0001
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BMC Medicine

ISSN: 1741-7015

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