The glomerular filtration rate in an apparently healthy population and its relation with cardiovascular mortality...

Area of Science:

• Nephrology
• Cardiology
• Epidemiology

Background:

• Moderate-to-severe chronic renal failure is a known cardiovascular disease risk factor.
• The impact of mild renal function decline on long-term cardiac outcomes is not well-established.
• The specific glomerular filtration rate (GFR) threshold for increased cardiovascular risk requires definition.

Purpose of the Study:

• To investigate the association between renal function, including mild decrements, and long-term cardiovascular morbidity and mortality.
• To determine the GFR cut-off level at which cardiovascular risk begins to increase.
• To assess renal function as an independent risk factor for cardiovascular mortality in a general population.

Main Methods:

• A 10-year follow-up of 8913 randomly selected, apparently healthy Belgian participants.
• GFR calculated using the modified 'Modification of Diet in Renal Disease' equation, with serum creatinine corrected to isotope dilution mass spectrometry.
• Cause-specific mortality ascertained through death certificate analysis, with adjustments for comorbid conditions.

Main Results:

• A higher probability of all-cause and cardiovascular mortality was observed across decreasing quartiles of GFR.
• This increased mortality risk was evident even after accounting for other cardiovascular risk factors.
• The detrimental effect on cardiovascular mortality was present even at relatively high GFR levels.

Conclusions:

• Mild renal failure is an independent predictor of 10-year cardiovascular mortality in an unselected, healthy population.
• Cardiovascular risk associated with renal impairment starts at a GFR of approximately 90 mL/min/1.73 m².
• Renal function is a critical, independent factor influencing long-term cardiovascular health and survival.