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Kidney function as a predictor of noncardiovascular mortality
Linda F Fried1, Ronit Katz, Mark J Sarnak
1VA Pittsburgh Healthcare System and Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15240, USA. linda.fried@med.va.gov
Journal of the American Society of Nephrology : JASN
|October 28, 2005
Summary
Chronic kidney disease predicts noncardiovascular mortality in older adults. Impaired kidney function, measured by cystatin C, increases the risk of death from causes like pulmonary disease and infection.
Area of Science:
- Gerontology
- Nephrology
- Epidemiology
Background:
- Chronic kidney disease (CKD) is a known risk factor for cardiovascular and all-cause mortality.
- The association between CKD and noncardiovascular mortality is less understood, particularly in elderly populations.
Purpose of the Study:
- To investigate the relationship between kidney function and noncardiovascular mortality in older individuals.
- To assess whether kidney function predicts cause-specific noncardiovascular mortality.
Main Methods:
- The Cardiovascular Health Study cohort, including 4637 older adults, assessed kidney function using cystatin C and estimated glomerular filtration rate (eGFR) in 1992-1993.
- Participants were followed until 2001, with deaths adjudicated for cardiovascular or noncardiovascular causes.
- Proportional hazards regression analyzed associations between kidney function and mortality outcomes.
Main Results:
- Noncardiovascular mortality rates significantly increased with higher cystatin C levels.
- The association between cystatin C and noncardiovascular mortality remained significant after adjusting for multiple confounders.
- Elevated cystatin C levels predicted noncardiac deaths from pulmonary disease, infection, and cancer.
Conclusions:
- Kidney function is a significant predictor of noncardiovascular mortality from various causes in the elderly.
- Further research is warranted to elucidate the underlying mechanisms and develop interventions to mitigate mortality risk in CKD patients.