Cardiovascular risk factor profiles and kidney function stage in the US general population: the NHANES III study.
OBJECTIVE
To determine the prevalence of cardiovascular risk factors in the general population based on kidney function.


METHODS
We retrospectively analyzed data from the Third National Health and Nutrition Examination Survey of noninstitutionalized US adults, which was conducted from 1988 to 1994. Data were gathered on 9 cardiovascular risk factors (smoking; obesity; hypertension; high total cholesterol, C-reactive protein, glycosylated hemoglobin, and homocysteine levels; low hemoglobin level; and high urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate (GFR).


RESULTS
For the 15,837 subjects, the estimated GFR was at least 90 mL/min per 1.73 m2 (normal) in 65.4%, 60 to 89.9 mL/ min per 1.73 m2 (stage 2 kidney function) in 27.9%, 30 to 59.9 mL/min per 1.73 m2 (stage 3 kidney function) in 6.2%, and less than 30 mL/min per 1.73 m2 (stages 4 and 5 kidney function) In 0.5%. The number of cardiovascular risk factors Increased with stage of kidney dysfunction. Of subjects with a normal GFR, 30.4% had no risk factors, 34.9% had 1 risk factor, and 34.7% had 2 or more risk factors. Of subjects with stage 2 kidney function, 24.8% had no risk factors, 30.3% had 1 risk factor, and 44.9% had 2 or more risk factors. Of subjects with stage 3 kidney function, 1.4% had no risk factors, 14.9% had 1 risk factor, and 83.6% had 2 or more risk factors. All subjects with stages 4 and 5 kidney function had 2 or more risk factors. After covariate adjustment, odds ratios for having an estimated GFR lower than 60 mL/min per 1.73 m2 were 1, 3.7 (95% confidence interval, 1.2-11.3), and 10.4 (95% confidence interval, 3.9-27.8) times greater in subjects with 0, 1, and 2 or more cardiovascular risk factors, respectively (P<.001).


CONCLUSIONS
Persons with chronic kidney disease are much more likely to need multiple cardiovascular risk factor interventions than those without chronic kidney disease.
Foley
Robert N
RN
United States Renal Data System, 914 S 8th St, Suite D253, Minneapolis, MN 55404, USA. RFoley@usrds.org
Wang
Changchun
C
Collins
Allan J
AJ
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood*; D002908:Chronic Disease; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D008078:Cholesterol, LDL