CardioExchange Archive

People with early-stage chronic kidney disease are at elevated risk for cardiovascular disease, according to a new study published in BMJ. Researchers from the U.K. and Iceland followed 17,000 adults in Reykjavik for a median of 24 years and found that people with chronic kidney disease at baseline had significantly elevated risk for cardiovascular events, and that adding information about chronic kidney disease to conventional risk factors improved prognostication. However, the incremental gain was lower than that provided by diabetes or smoking.

The U.K. and Icelandic authors acknowledge that “although plausible mechanisms have been proposed to suggest that impaired kidney function may itself be a causal factor in coronary heart disease, the possibility remains that chronic kidney disease is chiefly a marker of unfavourable cardiovascular risk profiles.”

In a second study appearing in BMJ, U.S. and Chinese investigators performed a meta-analysis of 284,672 participants in 33 prospective studies and found that low baseline eGFR was independently related to increased stroke risk. The risk was elevated more in Asian subjects.

In an accompanying editorial, Vlado Perkovic and Alan Cass write that the “evidence suggests that the presence of chronic kidney disease (either reduced eGFR or albuminuria, but especially both) should act as a ‘red flag’ that triggers cardiovascular risk assessment and implementation of appropriate preventive strategies.”