326. Measure of renal function a valuable tool to evaluate cardiovascular risk assessment

Henry, R.M.A.; Kostense, P. J.; Bos, G.
May 2003
Kidney;May/Jun2003, Vol. 12 Issue 3, p115
Academic Journal
Objective: To investigate the association of renal function with all-cause and cardiovascular mortality in a population-based cohort and explore potential mechanisms underlying any such relationship. Methodology: An age-, sex-, and glucose tolerance stratified sample (n = 631 ) of a population-based cohort aged 50-75 years was followed prospectively. After up to 10.2 years of follow-up, 117 subjects had died (50 of cardiovascular causes). Results: At baseline, metal age was 64 ± 7 years, 48% were men, 55% had hypertension, and 27% (by design) had type 2 diabetes. Serum creatinine was 91.7 ± 19.0 μmoL/L; creatinine clearance, as estimated by the Cockroft-Gault formula, was 72.5 ± 13.7 mL/min/1.73 m², and glomerular filtration rate (GFR), estimated by Levey's equation, was 67.8 ± 12.1 mL/min/1.73 m². Renal function was inversely associated with all-cause and with cardiovascular mortality. Ralative risks were 1.08 (1.04-1.13) and 1.11 (1.07-1.16) per 5 μmoL/L increase of serum creatinine; 1.07 (0.98-1.17) and 1.15 (1.01-1.31 ) for each decrease of 5 mL/min/1.73 m² creatinine clearance; and 1.15 (1.05-l.26) and 1.26 (1.12-1.42) for each decrease of 5 mL/min/1.73 m² of GFR. These associations remained alter adjusting for age, sex, glucose tolerance status, hypertension, prior cardiovascular disease, low-density lipoprotein cholesterol, homocysteine, (micro)athuminuria, von Willebrand factor, soluble vascular adhesion molecule 1, and C-reactive protein. Analyses of diabetic and hypertensive subjects gave similar results. Conclusion: Mild to moderate loss of renal function is strongly associated with an increased risk of cardiovascular mortality.


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