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Association between moderate renal insufficiency and cardiovascular events in a general population: Tehran lipid and
Farhad Hosseinpanah1, Maryam Barzin, Hosein Aghayan Golkashani
1Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. fhospanah@endocrine.ac.ir
Insights
Chronic kidney disease (CKD) was not an independent risk factor for cardiovascular disease (CVD) in this Tehranian population study. The association between CKD and CVD may be explained by other co-occurring traditional risk factors.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Chronic kidney disease (CKD) is a potential risk factor for cardiovascular disease (CVD), but evidence from community-based studies is conflicting.
- The interaction between CKD and body mass index (BMI) in relation to CVD risk requires further investigation.
Purpose of the Study:
- To evaluate the association between CKD and CVD events in a Tehranian population.
- To assess potential interactions between CKD and BMI on CVD risk.
Main Methods:
- A cohort of 6,209 participants from the Tehran Lipid and Glucose Study, free of prior CVD, were followed for 9.1 years.
- Glomerular filtration rate (GFR) was estimated using the MDRD formula to define CKD (eGFR <60 ml/min per 1.73 m²).
- Statistical analyses adjusted for age, sex, and other traditional CVD risk factors, and examined interactions with BMI categories.
Main Results:
- 22.2% of participants had CKD, predominantly stage 3a.
- Moderate CKD was not an independent predictor of CVD events after full adjustment (HR: 1.14, 95% CI 0.91-1.42).
- No significant interaction was found between CKD status and BMI categories concerning CVD risk (P = 0.2).
Conclusions:
- CKD is not an independent risk factor for CVD events in this community-based Tehranian cohort.
- The observed higher CVD prevalence in individuals with mild to moderate CKD may be attributed to the co-occurrence of traditional CVD risk factors.
Background:
Chronic kidney disease(CKD) has been proposed as a risk factor for cardiovascular disease (CVD). There is conflicting evidence among community based studies regarding the association between CKD and CVD. Furthermore, in order to assess the possible interaction between CKD and BMI, we also examined the association between CKD and CVD, across different BMI categories.
Methods:
The risk of CVD events was evaluated in a large cohort of participants selected from the Tehran Lipid and Glucose Study. Participants(mean age, 47.4 years) free of previous CVD were followed up for 9.1 years. GFR ml/min per 1.73 m(2) was estimated using the MDRD formula.
Results:
Of the 6,209 participants, 22.2%(1381) had CKD with eGFR ml/min per 1.73 m(2) <60 at baseline. Almost all of them (99%) were in stage 3a. Moderate renal insufficiency only predicted CVD outcomes independently when we adjusted for age and sex. After further adjustment, the presence of moderate CKD lost its statistical significance to confer an independent increased risk of CVD events with a hazard ratio of: HR: 1.14, CI 95% 0.91-1.42. Furthermore, when participants were categorized according to CKD status and BMI groups, after further adjustment, no interaction was found(P = 0.2).
Conclusion:
CKD was not an independent risk factor for CVD events in a community-based study in a Tehranian population and the higher prevalence of CVD in subjects with mild to moderate renal insufficiency might be due to the co-occurrence of traditional CVD risk factors in this group.
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