{"id":"49cf19811014","type":"article","url":"https://hartvaat.nl/2026/08/14/crp-en-albuminurie-duiden-op-hoog-risico-op-herhalende-hart-en-vaatziekten-bij-c/","title":"CRP en albuminurie duiden op hoog risico op herhalende hart- en vaatziekten bij chronische nierziekte — KNOW-CKD","title_en":"Risk factors for recurrent cardiovascular events in CKD: results from the KNOW-CKD study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Journal of nephrology","doi":"10.1093/joneph/aajag150","source_url":"https://doi.org/10.1093/joneph/aajag150","authors":["Eunjeong Kang","Dah Woon Im","Minsang Kim","Yaeni Kim","Tae-Hyun Yoo","Soo Wan Kim","Jayoun Kim","Kook-Hwan Oh"],"significance":5,"published":"2026-08-22","source_date":"2026-08-14","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/"],"congress":"","summary_en":"The prospective KNOW-CKD cohort followed 2,099 non-dialysis patients with chronic kidney disease for a median of 8.3 years to assess predictors of first and recurrent non-fatal cardiovascular events. Nine point seven percent of participants experienced at least one event; older age, diabetes, prior cardiovascular disease, elevated CRP, albuminuria, and lower BMI were consistently linked to recurrence, with CRP and albuminuria showing a particularly strong association with repeated events compared to initial ones. These findings highlight that cardiovascular risk stratification in CKD should extend beyond traditional metabolic factors to include markers of vascular injury and systemic inflammation, informing more comprehensive preventive strategies.","created":"2026-08-15T01:14:30Z","updated":"2026-08-15T01:14:30Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In de prospectieve KNOW-CKD-cohortstudie werden 2099 niet-dialysepatiënten met chronische nierziekte gemiddeld 8,3 jaar gevolgd op het ontstaan van niet-fatale hart- en vaatziekten. Na 8,3 jaar had 9,7% minstens één CV-gebeurtenis; ouderdom, diabetes, eerder CV-lijden, een verhoogd CRP, albuminurie en een laag BMI waren consistent geassocieerd met herhalende gebeurtenissen, waarbij CRP en albuminurie sterker correleerden met recidieven dan met de eerste gebeurtenis. Deze bevindingen benadrukken dat risicomanagement bij CKD niet alleen gericht moet zijn op traditionele factoren, maar ook op markers van vasculaire kwetsbaarheid en ontsteking om het cumulatieve CV-belasting te beperken.","abstract_original":"BACKGROUND: Chronic kidney disease (CKD) markedly increases cardiovascular (CV) risk, and some patients experience recurrent CV events over time. Analyses restricted to time-to-first event may therefore underestimate the total CV burden. We evaluated determinants of both first and recurrent non-fatal CV events in CKD. METHODS: We analyzed 2099 non-dialysis participants with CKD enrolled in the prospective KNOW-CKD cohort. CV events were adjudicated and included myocardial infarction, stroke, heart failure, coronary or peripheral revascularization, and clinically significant arrhythmias. Predictors of the first event were assessed using Cox proportional hazards models. Recurrent-event risk was evaluated using Andersen-Gill, Prentice-Williams-Peterson total-time and gap-time models, and shared-frailty models, complemented by mean cumulative function analyses. RESULTS: Over a median follow-up of 8.29 years, 203 participants (9.7%) experienced at least one non-fatal CV event (158 had one event, 39 had two, and 6 had three). Participants with baseline CV disease or diabetes exhibited substantially higher cumulative event burdens. Older age, diabetes, prior CV disease, higher C-reactive protein (CRP), albuminuria, and lower body mass index (BMI) were consistently associated with recurrent events across models; CRP and albuminuria showed relatively stronger associations with recurrence than with the first event. CONCLUSION: In CKD, recurrent CV risk is driven not only by traditional factors, particularly diabetes, but also by markers of vascular injury and inflammation. Strategies targeting both metabolic and inflammatory pathways may be critical to reducing recurrent CV burden."}