Related Experiment Video
Updated: May 4, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Refined characterization of the association between kidney function and mortality in patients undergoing cardiac
Brenda R Hemmelgarn1, Danielle A Southern, Karin H Humphries
1Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Patients with cardiovascular disease undergoing cardiac catheterization face increased mortality risk with declining kidney function. An estimated glomerular filtration rate below 79 mL/min/1.73 m² signals elevated death risk.
Area of Science:
- Nephrology
- Cardiology
- Clinical Epidemiology
Background:
- Chronic kidney disease (CKD) significantly elevates cardiovascular morbidity and mortality risks.
- The precise threshold of kidney function decline indicating increased risk in cardiovascular disease (CVD) patients is not well-defined.
Purpose of the Study:
- To investigate the relationship between kidney function, assessed by estimated glomerular filtration rate (eGFR), and survival in patients with CVD undergoing cardiac catheterization.
- To refine the understanding of eGFR as a prognostic marker in this patient population.
Main Methods:
- Analysis of 8521 patients undergoing cardiac catheterization from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database (1999-2001).
- Kidney function assessed using estimated glomerular filtration rate (eGFR) as both a categorical and continuous variable.
- All-cause mortality as the primary outcome, analyzed over a median follow-up of 2.2 years, with adjustments for clinical risk factors and coronary disease severity.
Main Results:
- A consistent decrease in survival was observed with declining eGFR categories (10 mL/min/1.73 m² decrements).
- An increased risk of death was identified when eGFR fell below 79 mL/min/1.73 m².
- For every 10 mL/min/1.73 m² decrease in eGFR below 70 mL/min/1.73 m², there was a 17.2% relative increase in mortality risk (95% CI 8.4-26.6%).
Conclusions:
- Elevated risk of death post-cardiac catheterization is associated with an eGFR of 79 mL/min/1.73 m² or lower.
- eGFR serves as a potent prognostic indicator for mortality in patients with CVD undergoing cardiac catheterization, offering refined risk stratification.
Aims:
Chronic kidney disease is associated with an increased risk of cardiovascular morbidity and mortality. The level of kidney function at which this risk increases remains to be determined. We sought to characterize the relationship between kidney function and survival among patients with cardiovascular disease (CVD) undergoing cardiac catheterization using estimated glomerular filtration rate (eGFR) and graded refinements in the classification of kidney function.
Methods And Results:
We included 8521 of 11 778 (72.3%) consecutive patients undergoing cardiac catheterization between 1 January 1999 and 31 December 2001 from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database. eGFR as a categorical and continuous variable was used to define kidney function. The outcome was all-cause mortality. During a median (interquartile range) follow-up of 2.2 (1.5-3.1) years, and after adjustment for clinical risk factors and severity of coronary disease, there was a steady incremental decrease in survival post-catheterization corresponding to a decline in eGFR categories of 10 mL/min/1.73 m(2). When eGFR was modelled as a continuous variable, there was an increased risk of death noted at an eGFR below 79 mL/min/1.73 m(2). Below an eGFR of 70 mL/min/1.73 m,(2), there was an approximate 17.2% relative increase in risk for every 10 unit decrease in eGFR (95% CI 8.4-26.6%).
Conclusion:
The risk of death post-cardiac catheterization is elevated when eGFR is < or =79 mL/min/1.73 m(2). These findings provide considerable refinement in our understanding of eGFR as a powerful prognostic marker in patients with CVD undergoing cardiac catheterization.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:26Cardiac Catheterization IV: Nursing Management
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:18Chronic Kidney Disease IV: Nursing Management