Causal relationship from heart failure to kidney function and CKD: A bidirectional two-sample mendelian randomization study

PLoS One. 2023 Dec 11;18(12):e0295532. doi: 10.1371/journal.pone.0295532. eCollection 2023.

Abstract

Background: Heart Failure (HF) is a widespread condition that affects millions of people, and it is caused by issues with the heart and blood vessels. Even though we know hypertension, coronary artery disease, obesity, diabetes, and genetics can increase the risk of HF and Chronic Kidney Disease (CKD), the exact cause of these conditions remains a mystery. To bridge this gap, we adopted Mendelian Randomization (MR), which relies on genetic variants as proxies.

Methods: We used data from European populations for our Bidirectional Two-Sample MR Study, which included 930,014 controls and 47,309 cases of HF from the HERMES consortium, as well as 736,396 controls and 51,256 cases of CKD. We also employed several MR variations, including MR-Egger, Inverse Variance Weighted (IVW), and Weighted Median Estimator (WME), to guarantee the results were accurate and comprehensive.).

Results: In this study, the MR analysis found that individuals with a genetic predisposition for HF have an elevated risk of CKD. Our study revealed a significant association between the genetic prediction of HF and the risk of CKD, as evidenced by the IVW method [with an odds ratio (OR) of 1.12 (95% CI, 1.03-1.21), p = 0.009] and the WME [with an OR of 1.14 (95% CI, 1.03-1.26), p = 0.008]. This causal relationship remained robust even after conducting MR analysis while adjusting for the effects of diabetes and hypertension, yielding ORs of 1.13 (IVW:95% CI, 1.03-1.23), 1.12 (MR-Egger: 95% CI, 0.85-1.48), and 1.15 (WME:95% CI, 1.04-1.27) (p = 0.008). However, in the reverse analysis aiming to explore CKD and renal function as exposures and HF as the outcome, we did not observe a statistically significant causal link between CKD and HF.

Conclusion: Our study demonstrates the significance of HF in CKD progression, thus having meaningful implications for treatment and the potential for discovering new therapies. To better understand the relationship between HF and CKD, we need to conduct research in a variety of populations.

MeSH terms

  • Diabetes Mellitus*
  • Genome-Wide Association Study
  • Heart Failure* / genetics
  • Humans
  • Hypertension*
  • Kidney
  • Mendelian Randomization Analysis
  • Renal Insufficiency, Chronic* / genetics

Grants and funding

This work was supported by National Natural Science Foundation of China (Grant No.82274412); Natural Science Foundation of Hunan Province China (Grant No.2020JJ4062, No.2020JJ5408); R&d projects in key areas of Guangdong Province(Grant No.2020B1111100001); Hunan Provincial Department of Education project(Grant No.21A0230, 21B0361). The funders had no role in study design, data collection and analysis.