Impaired renal function and atherosclerosis in a Pakistani cohort

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• Coronary arterial disease (CAD) is a significant health concern.
• Renal function, assessed by creatinine and glomerular filtration rate (GFR), plays a role in cardiovascular health.
• The relationship between renal function and CAD in Pakistani populations requires further investigation.

Purpose of the Study:

• To investigate the association between creatinine and calculated GFR with CAD in Pakistani patients.
• To determine if impaired renal function is a risk factor for atherosclerosis in this population.

Main Methods:

• A prospective case-control study was conducted.
• Four hundred individuals presenting with chest pain were included: 200 with angiographically confirmed occlusive disease and 200 without.
• Renal function was assessed using Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulae.

Main Results:

• Impaired renal function, indicated by calculated GFR, was prevalent in the study population.
• Both creatinine and GFR were significantly associated with CAD and atherosclerotic burden.
• A higher prevalence of significant renal impairment (GFR < 60 mL/min/1.73 m2) was observed in patients with CAD compared to controls (18.5% vs. 6.5% by CG; 26% vs. 9% by MDRD).
• The odds ratios for CAD associated with GFR < 60 mL/min/1.73 m2 remained significant even after adjusting for diabetes, smoking, insulin resistance, inflammation, and apolipoprotein A1.

Conclusions:

• Impaired renal function is common among Pakistani patients suffering from coronary arterial disease.
• Renal impairment is a significant risk factor for atherosclerosis in this patient group.
• The association between impaired renal function and atherosclerosis is independent of insulin resistance.