#2569 HEART FAILURE AND DIABETES IN CHRONIC KIDNEY DISEASE

Abstract Background and Aims Few studies have investigated the prognosis in chronic kidney disease (CKD) patients with heart failure (HF) diabetes (DM). In clinical setting, treating a combination of these conditions is challenging but novel treatments such as SGLT2-inhibitors are now emerging. The aim this study to investigate prevalence outcomes survival major cardiovascular events (MACE) CKD HF and/or DM before new were commonly used. Method retrospective observational study, we extracted data from 26647 nephrology-referred ≥18 years old eGFR 60 ≤ ml/min/1,73 m2 Swedish Renal Registry – Chronic Kidney Disease (SRR-CKD) health registers at National Board Health Welfare Sweden during an period January 2005 June 2017. was categorized based on International Classification 10 (ICD-10) diagnostic codes prior inclusion SRR-CKD. Outcomes death by any cause MACE, defined composite hospitalization for nonfatal myocardial infarction, coronary disease, congestive failure, stroke or death. Secondary outcome start replacement therapy (KRT) dialysis transplantation. Results There 12910 (47.7%) CKD, 3458 (12.5%) CKD+HF, 7595 (27.3%) CKD+DM 3684 (13.3%) CKD+HF+DM. Median age higher cohorts (CKD+HF CKD+HF+DM), 77 74 vs 67 69 (CKD CKD+DM). Most men all four groups (62-66%). use evidence therapies ACE-inhibitors/ARBs, varied across between 62.9, 66.6, 78.5 78.7% (CKD, CKD+DM, CKD+HF+DM). Statins used 42.0, 50.7, 71.1 73.7% betablockers 53.9, 83.7, 65.9, 86.1%. Survival presented Kaplan-Meier curve (Figure 1). Adjusted hazard ratio (HR) cause-death highest CKD+HF (2.54 [95% CI 2.40–2.68]) CKD+DM+HF (3.22 [3.05–3.39]) followed (HR 1.53 [1.45–1.60]) compared only CKD. cumulative incidence MACE illustrated below 2). HR substantially 3.82 (3.62–4.03) 4.82 (4.59–5.08) CKD+HF+DM respectively while it 1.63 (1.56–1.72) CKD+DM. risk initiation KRT similar groups, HF. Conclusion CKD-patients, diagnosis comprises approximately three times greater most severe. patient evidence-based surprisingly low. This may reflect both deviation guidelines CKD-patients challenge comorbidities CKD-patients. results underlie importance identifying early optimize treatment.