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Endothelial dysfunction contributes to renal function-associated cardiovascular mortality in a population with mild renal insufficiency: the Hoorn study.
J Am Soc Nephrol. 2006 Feb; 17(2):537-45.JA

Abstract

Mildly impaired renal function is associated with cardiovascular morbidity and mortality. There are indications that endothelial dysfunction and/or chronic inflammation, which play an important role in atherothrombosis, are present in early stages of renal insufficiency. This study investigated whether and to which extent endothelial dysfunction and inflammation were related to renal function and contributed to renal function-associated cardiovascular mortality in a population-based cohort (n = 613), aged 50 to 75 yr, that was followed with a median duration of 12.5 yr. During follow-up, 192 individuals died (67 of cardiovascular causes). At baseline, renal function was estimated with serum creatinine, the Cockcroft-Gault formula, and the Modification of Diet in Renal Disease equation of GFR (eGFR). Endothelial function was estimated by plasma von Willebrand factor, soluble vascular cell adhesion molecule-1, and the urinary albumin-creatinine ratio. Inflammatory activity was estimated by plasma C-reactive protein and soluble intercellular adhesion molecule-1. Renal function was mildly impaired (mean eGFR 68 +/- 12 ml/min per 1.73 m(2)) and independently associated with von Willebrand factor (standardized beta -0.09; 95% confidence interval [CI] -0.18 to -0.002; P < 0.05), soluble vascular cell adhesion molecule-1 (standardized beta -0.14; 95% CI -0.22 to -0.05; P < 0.01), and albumin-creatinine ratio (standardized beta -0.15; 95% CI -0.23 to -0.08; P < 0.001) but not with markers of inflammatory activity. Renal function was inversely associated with cardiovascular and all-cause mortality. The relative risk for cardiovascular mortality but not all-cause mortality associated with renal function decreased from 1.22 to 1.12 per 5 ml/min per 1.73 m(2) decrease of eGFR after adjustment for markers of endothelial dysfunction. In conclusion, endothelial dysfunction was related to renal function and contributed to the excess in cardiovascular mortality in this population-based cohort with mild renal insufficiency.

Authors+Show Affiliations

Department of Internal Medicine, Academic Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16382015

Citation

Stam, Frank, et al. "Endothelial Dysfunction Contributes to Renal Function-associated Cardiovascular Mortality in a Population With Mild Renal Insufficiency: the Hoorn Study." Journal of the American Society of Nephrology : JASN, vol. 17, no. 2, 2006, pp. 537-45.
Stam F, van Guldener C, Becker A, et al. Endothelial dysfunction contributes to renal function-associated cardiovascular mortality in a population with mild renal insufficiency: the Hoorn study. J Am Soc Nephrol. 2006;17(2):537-45.
Stam, F., van Guldener, C., Becker, A., Dekker, J. M., Heine, R. J., Bouter, L. M., & Stehouwer, C. D. (2006). Endothelial dysfunction contributes to renal function-associated cardiovascular mortality in a population with mild renal insufficiency: the Hoorn study. Journal of the American Society of Nephrology : JASN, 17(2), 537-45.
Stam F, et al. Endothelial Dysfunction Contributes to Renal Function-associated Cardiovascular Mortality in a Population With Mild Renal Insufficiency: the Hoorn Study. J Am Soc Nephrol. 2006;17(2):537-45. PubMed PMID: 16382015.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endothelial dysfunction contributes to renal function-associated cardiovascular mortality in a population with mild renal insufficiency: the Hoorn study. AU - Stam,Frank, AU - van Guldener,Coen, AU - Becker,Annemarie, AU - Dekker,Jacqueline M, AU - Heine,Robert J, AU - Bouter,Lex M, AU - Stehouwer,Coen D A, Y1 - 2005/12/28/ PY - 2005/12/31/pubmed PY - 2006/6/23/medline PY - 2005/12/31/entrez SP - 537 EP - 45 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 17 IS - 2 N2 - Mildly impaired renal function is associated with cardiovascular morbidity and mortality. There are indications that endothelial dysfunction and/or chronic inflammation, which play an important role in atherothrombosis, are present in early stages of renal insufficiency. This study investigated whether and to which extent endothelial dysfunction and inflammation were related to renal function and contributed to renal function-associated cardiovascular mortality in a population-based cohort (n = 613), aged 50 to 75 yr, that was followed with a median duration of 12.5 yr. During follow-up, 192 individuals died (67 of cardiovascular causes). At baseline, renal function was estimated with serum creatinine, the Cockcroft-Gault formula, and the Modification of Diet in Renal Disease equation of GFR (eGFR). Endothelial function was estimated by plasma von Willebrand factor, soluble vascular cell adhesion molecule-1, and the urinary albumin-creatinine ratio. Inflammatory activity was estimated by plasma C-reactive protein and soluble intercellular adhesion molecule-1. Renal function was mildly impaired (mean eGFR 68 +/- 12 ml/min per 1.73 m(2)) and independently associated with von Willebrand factor (standardized beta -0.09; 95% confidence interval [CI] -0.18 to -0.002; P < 0.05), soluble vascular cell adhesion molecule-1 (standardized beta -0.14; 95% CI -0.22 to -0.05; P < 0.01), and albumin-creatinine ratio (standardized beta -0.15; 95% CI -0.23 to -0.08; P < 0.001) but not with markers of inflammatory activity. Renal function was inversely associated with cardiovascular and all-cause mortality. The relative risk for cardiovascular mortality but not all-cause mortality associated with renal function decreased from 1.22 to 1.12 per 5 ml/min per 1.73 m(2) decrease of eGFR after adjustment for markers of endothelial dysfunction. In conclusion, endothelial dysfunction was related to renal function and contributed to the excess in cardiovascular mortality in this population-based cohort with mild renal insufficiency. SN - 1046-6673 UR - https://www.unboundmedicine.com/medline/citation/16382015/Endothelial_dysfunction_contributes_to_renal_function_associated_cardiovascular_mortality_in_a_population_with_mild_renal_insufficiency:_the_Hoorn_study_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=16382015 DB - PRIME DP - Unbound Medicine ER -