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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Albuminuria, impaired kidney function and cardiovascular outcomes or mortality in the elderly

Dena E Rifkin1, Ronit Katz, Michel Chonchol

  • 1Tufts Medical Center and Tufts University School of Medicine, University of Washington, Seattle, USA. drifkin@ucsd.edu

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|December 17, 2009
PubMed

Insights

Kidney disease markers, albuminuria and cystatin C, significantly increase mortality risk in older adults. Early detection of preclinical kidney disease or microalbuminuria is crucial for assessing cardiovascular and mortality risks.

Area of Science:

  • Gerontology
  • Nephrology
  • Cardiology

Background:

  • Kidney disease is a significant risk factor for mortality and cardiovascular disease in older adults.
  • The independent and combined effects of albuminuria and cystatin C on these outcomes are not fully understood.

Purpose of the Study:

  • To investigate the associations of albuminuria and cystatin C with mortality and cardiovascular outcomes in older adults.
  • To differentiate the risks associated with normal kidney function, preclinical kidney disease, and chronic kidney disease (CKD).

Main Methods:

  • Analysis of data from 3291 older adults in the Cardiovascular Health Study with a median follow-up of 8.3 years.
  • Assessment of kidney disease using urinary albumin/creatinine ratio (ACR) and cystatin C levels.
  • Categorization into subgroups: normal kidney function, preclinical kidney disease, and CKD, with stratification for microalbuminuria (MA).

Main Results:

  • 34.9% had normal kidney function, 46.1% had preclinical kidney disease, and 18.9% had CKD.
  • Preclinical kidney disease or MA independently increased mortality risk by over 50%.
  • The combination of CKD and MA presented the highest mortality risk, nearly 4-fold.

Conclusions:

  • Elevated cystatin C and albuminuria are prevalent in older adults.
  • These markers identify distinct population subsets at risk.
  • Both are independent, graded risk factors for cardiovascular disease and mortality.
Abstract

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