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Updated: Apr 2, 2026
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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Chronic Kidney Disease Screening in Patients With Coronary Heart Disease: The Multinational INTERASPIRE Study
Safi Moayad Al-Azzawy1, Dirk De Bacquer2, John William McEvoy3
1Department of Medicine Solna, Karolinska Institutet, FoU-Tema Hjärta och Kärl, Stockholm, Sweden.
Journal of the American College of Cardiology
|April 1, 2026
Summary
Chronic kidney disease (CKD) screening is crucial for coronary artery disease (CAD) patients. Including urinary albumin/creatinine ratio (UACR) with estimated glomerular filtration rate (eGFR) detects more CKD cases and improves risk assessment.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Chronic kidney disease (CKD) significantly increases the risk of coronary artery disease (CAD) progression.
- CKD affects a substantial portion of patients with established CAD.
Purpose of the Study:
- To determine the prevalence of CKD in CAD patients across diverse global regions.
- To assess the prognostic significance of estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio (UACR) in these patients.
Main Methods:
- Analysis of 4,548 CAD patients from 14 countries, assessing eGFR and UACR 6-24 months post-diagnosis.
- Follow-up data for 3,577 patients (92.5%) after a median of 1 year.
- Evaluation of cardio-renal protective therapy use.
Main Results:
- CKD was present in 32% of CAD patients, with 5.6% classified as very high risk.
- Excluding UACR would have missed 51.3% of CKD cases.
- A primary composite event (cardiovascular death, MI, stroke, HF hospitalization) occurred in 7.9%, highest in the high-risk CKD group.
Conclusions:
- Early CKD screening in CAD patients, utilizing both eGFR and UACR, is essential for accurate diagnosis and risk stratification.
- UACR is critical, as it identifies nearly half of CKD cases missed by eGFR alone.
- Low rates of cardio-renal protective therapy highlight a significant opportunity for clinical improvement.
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