New research was presented at Kidney Week 2020 Reimagined, the virtual annual meeting of the American Society of Nephrology.
Although chronic kidney disease has been shown to be associated with adverse outcomes in patients with established cardiovascular disease (CVD) or diabetes, medications to treat CVD in patients with low estimated glomerular filtration rate (eGFR) may be ineffective. The Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) randomized patients with CVD or diabetes and one additional risk factor to treatment with icosapent ethyl or placebo. The primary endpoint (5-point major adverse cardiovascular events [MACE] consisting of non-fatal myocardial infarction [MI], stroke, cardiovascular death, unstable angina requiring hospitalization and coronary revascularization) and key secondary endpoint (3-point MACE consisting of non-fatal MI, stroke and cardiovascular death) events were consistently reduced when looking at data cut by prespecified baseline eGFR categories; eGFR <60 mL/min/1.73 m2, eGFR ≥60 to <90 mL/min/1.73 m², and eGFR ≥90 mL/min/1.73 m². Similar consistent cardiovascular risk reduction benefits were observed across post hoc analyses by finer cuts of eGFR categories. Primary and key secondary endpoint MACE rates increased with decreasing eGFR compared to the total patient population studied in REDUCE-IT, resulting in similarly favorable relative risk reductions and numerically greater absolute risk reductions with icosapent ethyl versus placebo in comparison with the overall patient population. Adverse event rates were higher with decreasing eGFR, but total adverse events occurred at similar rates in both groups.