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Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency.
Kidney Int. 1999 Dec; 56(6):2214-9.KI

Abstract

Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency.

BACKGROUND

Little is known about the prevalence of cardiovascular disease (CVD) and associated risk factors in individuals with mild renal insufficiency (RI). Furthermore, the long-term outcomes associated with mild RI in the community have not been described.

METHODS

Serum creatinine (SCr) was measured in 6233 adult participants of the Framingham Heart Study (mean age 54 years, 54% women). Mild RI was defined as SCr 136 to 265 micromol/liter (1.5 to 3.0 mg/dl) in men and 120 to 265 micromol/liter (1.4 to 3.0 mg/dl) in women. The lower limits for mild RI were defined by the sex-specific 95th percentile SCr values in a healthy subgroup of our sample. The upper limit for mild RI was chosen to exclude those subjects with more advanced renal failure. Cox proportional hazards analyses were used to determine the relationship of baseline RI to CVD and all-cause mortality.

RESULTS

At baseline, 8.7% of men (N = 246) and 8.0% of women (N = 270) had mild RI. Nineteen percent of the subjects with mild RI had prevalent CVD. During 15 years of follow-up, there were 1000 CVD events and 1406 deaths. In women, mild RI was not associated with increased risk for CVD events [hazards ratio (HR) 1.04, 95% CI, 0.79 to 1.37] or all-cause mortality (HR 1.08, 95% CI, 0.87 to 1.34). In men, mild RI showed no significant associations with CVD events (HR 1.17, 95% CI, 0.88 to 1.57), but it was associated with all-cause mortality in age-adjusted (HR 1.42, 95% CI, 1.12 to 1.79) and multivariable adjusted (HR 1.31, 95% CI, 1.02 to 1.67) analyses.

CONCLUSION

Mild RI in the community is common and is associated with a high prevalence of CVD. The association of RI with risk for adverse outcomes is strongly related to coexisting CVD and CVD risk factors.

Authors+Show Affiliations

National Heart, Lung, and Blood Institute's Framingham Heart Study, MA 01702, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

10594797

Citation

Culleton, B F., et al. "Cardiovascular Disease and Mortality in a Community-based Cohort With Mild Renal Insufficiency." Kidney International, vol. 56, no. 6, 1999, pp. 2214-9.
Culleton BF, Larson MG, Wilson PW, et al. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int. 1999;56(6):2214-9.
Culleton, B. F., Larson, M. G., Wilson, P. W., Evans, J. C., Parfrey, P. S., & Levy, D. (1999). Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney International, 56(6), 2214-9.
Culleton BF, et al. Cardiovascular Disease and Mortality in a Community-based Cohort With Mild Renal Insufficiency. Kidney Int. 1999;56(6):2214-9. PubMed PMID: 10594797.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. AU - Culleton,B F, AU - Larson,M G, AU - Wilson,P W, AU - Evans,J C, AU - Parfrey,P S, AU - Levy,D, PY - 1999/12/14/pubmed PY - 1999/12/14/medline PY - 1999/12/14/entrez SP - 2214 EP - 9 JF - Kidney international JO - Kidney Int VL - 56 IS - 6 N2 - UNLABELLED: Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. BACKGROUND: Little is known about the prevalence of cardiovascular disease (CVD) and associated risk factors in individuals with mild renal insufficiency (RI). Furthermore, the long-term outcomes associated with mild RI in the community have not been described. METHODS: Serum creatinine (SCr) was measured in 6233 adult participants of the Framingham Heart Study (mean age 54 years, 54% women). Mild RI was defined as SCr 136 to 265 micromol/liter (1.5 to 3.0 mg/dl) in men and 120 to 265 micromol/liter (1.4 to 3.0 mg/dl) in women. The lower limits for mild RI were defined by the sex-specific 95th percentile SCr values in a healthy subgroup of our sample. The upper limit for mild RI was chosen to exclude those subjects with more advanced renal failure. Cox proportional hazards analyses were used to determine the relationship of baseline RI to CVD and all-cause mortality. RESULTS: At baseline, 8.7% of men (N = 246) and 8.0% of women (N = 270) had mild RI. Nineteen percent of the subjects with mild RI had prevalent CVD. During 15 years of follow-up, there were 1000 CVD events and 1406 deaths. In women, mild RI was not associated with increased risk for CVD events [hazards ratio (HR) 1.04, 95% CI, 0.79 to 1.37] or all-cause mortality (HR 1.08, 95% CI, 0.87 to 1.34). In men, mild RI showed no significant associations with CVD events (HR 1.17, 95% CI, 0.88 to 1.57), but it was associated with all-cause mortality in age-adjusted (HR 1.42, 95% CI, 1.12 to 1.79) and multivariable adjusted (HR 1.31, 95% CI, 1.02 to 1.67) analyses. CONCLUSION: Mild RI in the community is common and is associated with a high prevalence of CVD. The association of RI with risk for adverse outcomes is strongly related to coexisting CVD and CVD risk factors. SN - 0085-2538 UR - https://www.unboundmedicine.com/medline/citation/10594797/Cardiovascular_disease_and_mortality_in_a_community_based_cohort_with_mild_renal_insufficiency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)46558-5 DB - PRIME DP - Unbound Medicine ER -