Renal function and cardiovascular mortality in elderly men: the role of inflammatory, procoagulant, and endothelial...

Area of Science:

• Cardiovascular epidemiology
• Nephrology
• Biomarker research

Background:

• Diminished renal function is a known risk factor for cardiovascular disease.
• The specific mechanisms linking reduced kidney function to cardiovascular mortality are not fully elucidated.
• Inflammatory, procoagulant, and endothelial biomarkers may play a mediating role.

Purpose of the Study:

• To investigate the extent to which inflammatory, procoagulant, and endothelial biomarkers modify the association between reduced renal function and cardiovascular mortality.
• To quantify the contribution of these biomarkers to cardiovascular risk in elderly men with varying degrees of kidney function.

Main Methods:

• Prospective study of 4029 men aged 60-79 years.
• Estimated glomerular filtration rate (eGFR) used to measure renal function.
• Follow-up for a mean of 6 years, recording 304 cardiovascular deaths.
• Analysis of inflammatory (IL-6, CRP), endothelial (vWF, tPA), and coagulation (D-dimer) markers.

Main Results:

• Reduced eGFR was associated with increased cardiovascular risk factors and higher levels of inflammatory, endothelial, and coagulation markers.
• Cardiovascular mortality risk increased with decreasing eGFR, particularly below 60 mL/min/1.73 m².
• The association between reduced eGFR and cardiovascular mortality was attenuated after adjusting for vWF, D-dimer, and IL-6.

Conclusions:

• Mild-to-moderate renal insufficiency is linked to significantly increased cardiovascular mortality in elderly men.
• This increased risk is partly mediated by established cardiovascular risk factors.
• Inflammatory, coagulation, and endothelial markers partially explain the relationship between reduced renal function and cardiovascular mortality.