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Updated: Jul 7, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Renal function as a risk indicator for cardiovascular events in 3216 patients with manifest arterial disease
Liesbeth Bax1, Ale Algra, Willem P Th M Mali
1Department of Radiology, University Medical Center Utrecht, The Netherlands.
Insights
Impaired kidney function significantly increases cardiovascular disease (CVD) risk and mortality in high-risk patients. Moderate to severe renal insufficiency independently predicts adverse vascular events and death, regardless of other risk factors.
Area of Science:
- Nephrology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- The role of impaired renal function as an independent predictor of CVD in high-risk populations requires further elucidation.
Purpose of the Study:
- To determine if reduced kidney function independently predicts cardiovascular disease (CVD) and mortality.
- To assess the impact of renal insufficiency on adverse outcomes in patients with established CVD.
Main Methods:
- A cohort of 3216 patients with existing CVD was studied.
- Estimated glomerular filtration rate (GFR) was calculated using the MDRD equation.
- Outcomes included vascular events and all-cause mortality over a median 39-month follow-up.
Main Results:
- Patients with estimated GFR ≤ 60 ml/min/1.73 m² had a 1.8-fold increased risk of vascular events compared to those with GFR > 90 ml/min/1.73 m².
- A trend towards increased all-cause mortality was observed (HR 1.4).
- Renal function's impact was consistent across subgroups defined by vascular disease location or presence of hypertension, diabetes, or albuminuria.
Conclusions:
- Moderate to severe renal insufficiency is an independent risk factor for adverse cardiovascular events in high-risk individuals.
- The predictive value of renal function for CVD events is significant, independent of other common risk factors.
Aim:
To establish whether impaired renal function is an independent predictor of cardiovascular disease (CVD) and death in an unselected high-risk population with CVD.
Methods And Results:
In 3216 patients with CVD, the estimated glomerular filtration rate (GFR) was assessed with the Modification of Diet in Renal Disease (MDRD)-equation. Primary outcomes were all vascular events (including stroke, myocardial infarction, end-stage renal disease and vascular death) and all cause death. During a median follow-up of 39 months, 378 patients had a vascular event (11.7%) and 337 patients died (10.5%). The adjusted hazard ratio (HR) of an estimated GFR
Conclusions:
The presence of moderate to severe renal insufficiency is an independent risk factor for adverse CVD events in high-risk patients with a history of vascular disease. Localization of vascular disease or presence of other risk factors had no influence on the impact of renal function alone.
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