Chronic kidney disease and cardiovascular disease risk: exploring the role of socioeconomic position in a large cohort from Northwest Italy.

Background: Chronic kidney disease (CKD) is a global health concern, acknowledged as a major contributor to cardiovascular diseases (CVD). However, its impact within the Italian population is still poorly understood, with limited research exploring the role of socioeconomic factors in this relationship. Our study aims to investigate the CVD risks in CKD patients and the role of socioeconomic position (SEP) in Italy, using data from the Piedmont Longitudinal Study.

Methods: We included all individuals aged 60-80, resident in the Piedmont region. Validated algorithms were used to identify CKD and CVD from the 1^st January 2013 until the 31^st December 2018. We used cause-specific Cox proportional hazard models to investigate the risk of CVD, fatal and non-fatal CVD, coronary heart disease (CHD) and cerebrovascular events in subjects with CKD.

Results: The cohort included 1,010,180 individuals, with 31,299 incident cases of CKD identified during the follow-up. CKD patients were older, mostly males, and had lower socioeconomic position. CKD subjects faced an increased risk for all outcomes compared to non-CKD individuals, with a 2.64-fold higher risk of all CVD events. Stratification by SEP highlighted consistently elevated risks for CKD subjects, with the lowest socioeconomic position associated with the highest risk.

Conclusions: The study emphasized the significant association between CKD and CVD persisting across socioeconomic strata. The findings highlight socioeconomic disparities, emphasizing the importance of a multidisciplinary care approach and further research to address inequalities in the CKD-CVD relationship.