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[Occult chronic kidney disease in patients with stable coronary heart disease]

Carlos Lahoz1, José M Mostaza, María Teresa Mantilla

  • 1Unidad de Arteriosclerosis, Hospital Carlos III, Madrid, Spain. clahoz.hciii@salud.madrid.org

Medicina Clinica
|September 9, 2008
PubMed

Insights

Nearly one in four patients with stable coronary heart disease have chronic kidney disease (CKD), often with normal creatinine levels. This highlights the need for better detection of occult CKD in this high-risk population.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Context:

  • Chronic kidney disease (CKD) significantly elevates cardiovascular risk, particularly in patients with existing coronary heart disease (CHD).
  • Undiagnosed or occult CKD (OCKD) presents a challenge in managing cardiovascular risk in stable CHD patients.
  • Accurate prevalence data and associated factors for OCKD are crucial for timely intervention.

Purpose:

  • To determine the prevalence of OCKD in patients with stable coronary heart disease.
  • To identify clinical factors associated with OCKD in this patient cohort.
  • To inform strategies for improved OCKD detection and management.

Summary:

  • A cross-sectional study of 7,884 stable coronary heart disease patients revealed a 22.4% prevalence of CKD, with 68.3% of these cases being OCKD (normal serum creatinine).
  • OCKD patients exhibited an intermediate risk profile between those without CKD and those with CKD and elevated creatinine.
  • Multivariate analysis identified age, female sex, hypertension, diabetes, heart failure, cerebrovascular disease, and peripheral artery disease as independent predictors of OCKD.

Impact:

  • The findings underscore that nearly a quarter of stable CHD patients have CKD, often undetected due to normal creatinine levels.
  • This emphasizes the importance of screening for CKD in stable CHD patients, especially older women and those with multiple comorbidities.
  • Improved OCKD detection can lead to better cardiovascular risk stratification and management in this vulnerable population.
Abstract

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