Moderate renal insufficiency and the risk of cardiovascular mortality: results from the NHANES I

Kidney International
Amit X GargAndrew A House

Abstract

Conflicting evidence exists concerning whether renal insufficiency is an independent risk factor for cardiovascular disease in the general population. The objective of this study was to determine whether moderate renal insufficiency was associated with total and cardiovascular mortality, independent of traditional cardiovascular risk factors, in a community sample representative of the U.S. general non-institutionalized population. Participants in the U.S. First National Health and Nutrition Examination Survey (NHANES I, 1974-1975) and NHANES I Epidemiologic Follow-up Study (NHEFS, 1992, 18 year follow-up) were evaluated. The primary analysis was limited to 2352 adults with complete data, and no baseline cardiovascular disease. A creatinine of 104 to 146 micromol/L in women, and 122 to 177 micromol/L in men (approximate glomerular filtration rate of 30 to 60 mL/min/1.73 m2) was defined as moderate renal insufficiency. Supplementary analyses included participants with marked renal impairment and baseline cardiovascular disease. The unadjusted hazard ratio for moderate renal insufficiency compared to preserved renal function was significant for total mortality (hazard ratio 1.7; 95% confidence interval 1.3 to 2.2), and for cardio...Continue Reading

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