Risk Factors for Progressive Cardiorenal Syndrome Events in Patients with Chronic Kidney Disease: The CRIC Study

In adults with chronic kidney disease in the CRIC cohort (n = 3,557), 4.5% developed progressive cardiorenal syndrome within 12 months, defined by incident heart failure and ESKD.

• Why it matters: Progressive cardiorenal syndrome predicts poor outcomes, but its risk factors in people with CKD—especially those beyond traditional clinical measures—remain unclear.
• What they did: Excluding baseline heart failure, investigators used Cox proportional hazards models to test baseline predictors of progressive CRS, with a sensitivity analysis separating cases where HF occurred before ESKD versus vice versa.
• The result: Lower education (HR 1.90), cardiovascular disease (HR 1.53), lower eGFR (HR 0.64), and higher albumin-to-creatinine ratio (HR 2.44) were linked to progressive CRS, alongside novel markers including alkaline phosphatase, BNP, TNF-α, and GDF-15.

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