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Rapid decline of kidney function increases cardiovascular risk in the elderly.
Tuesday,2012-11-06 12:18 America/Los_Angeles — eenright
| Title | Rapid decline of kidney function increases cardiovascular risk in the elderly. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | Shlipak, MG, Katz, R, Kestenbaum, B, Siscovick, D, Fried, L, Newman, A, Rifkin, D, Sarnak, MJ |
| Journal | J Am Soc Nephrol |
| Volume | 20 |
| Issue | 12 |
| Pagination | 2625-30 |
| Date Published | 2009 Dec |
| ISSN | 1533-3450 |
| Keywords | Aged, Aged, 80 and over, Cardiovascular Diseases, Creatinine, Cystatin C, Female, Glomerular Filtration Rate, Heart Failure, Humans, Longitudinal Studies, Male, Myocardial Infarction, Peripheral Vascular Diseases, Renal Insufficiency, Chronic, Risk Factors, Stroke, Time Factors, United States |
| Abstract | <p>Chronic kidney disease (CKD), defined at a specific time point, is an important risk factor for cardiovascular disease. Whether the rate of kidney function decline contributes additional cardiovascular risk is unknown. In the Cardiovascular Health Study, we compared the associations of changes in kidney function during the first 7 yr with the incidence of heart failure (HF), myocardial infarction (MI), stroke, and peripheral arterial disease (PAD) during the subsequent 8 yr. We defined a rapid decline in cystatin C-based estimated GFR as >3 ml/min per 1.73 m(2)/yr, on the basis of determination at baseline, year 3, and year 7. Among eligible participants, 1083 (24%) had rapid kidney decline. The incidence of each type of cardiovascular event was significantly higher among patients with rapid decline (all P < 0.001). After multivariate adjustment for demographics, cardiovascular disease risk factors, and baseline kidney function, rapid kidney function decline was significantly associated with HF (adjusted hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.13 to 1.53), MI (HR 1.48; 95% CI 1.21 to 1.83), and PAD (HR 1.67; 95% CI 1.02 to 2.75) but not with stroke (HR 1.19; 95% CI 0.97 to 1.45). The association of rapid decline with each outcome did not differ by the presence or absence of CKD. In conclusion, declining kidney function associates with higher risk for HF, MI, and PAD among patients with or without CKD.</p> |
| DOI | 10.1681/ASN.2009050546 |
| Alternate Journal | J. Am. Soc. Nephrol. |
| PubMed ID | 19892934 |
| PubMed Central ID | PMC2794238 |
| Grant List | R01 AG027002 / AG / NIA NIH HHS / United States R01 DK066488 / DK / NIDDK NIH HHS / United States |