title: Cardiovascular risk factors and incident acute renal failure in older adults: the cardiovascular health study.
abstract: OBJECTIVE
  Although the elderly are at increased risk for acute renal failure, few prospective studies have identified risk factors for acute renal failure in the elderly.
  
  
  METHODS
  The associations of cardiovascular disease risk factors, subclinical cardiovascular disease, and clinical coronary heart disease with the risk for development of acute renal failure were examined in older adults in the Cardiovascular Health Study, a prospective cohort study of community-dwelling older adults. Incident hospitalized cases of acute renal failure were identified through hospital discharge International Classification of Diseases, Ninth Revision codes and confirmed through physician diagnoses of acute renal failure in discharge summaries.
  
  
  RESULTS
  Acute renal failure developed in 225 (3.9%) of the 5731 patients during a median follow-up period of 10.2 yr. In multivariate analyses, diabetes, current smoking, hypertension, C-reactive protein, and fibrinogen were associated with acute renal failure. Prevalent coronary heart disease was associated with incident acute renal failure, and among patients without prevalent coronary heart disease, subclinical vascular disease measures were also associated with acute renal failure: Low ankle-arm index (< or =0.9), common carotid intima-media thickness, and internal carotid intima-media thickness.
  
  
  CONCLUSIONS
  In this large, population-based, prospective cohort study, cardiovascular risk factors and both subclinical and clinical vascular disease were associated with incident acute renal failure in the elderly.
authors.affiliation: Division of Nephrology & Hypertension, Department of Medicine, Mail Code MQ360, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239, USA. mittalhe@ohsu.edu
authors.forename: Anuja
authors.initials: A
authors.lastname: Mittalhenkle
authors.forename: Catherine O
authors.initials: CO
authors.lastname: Stehman-Breen
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Linda F
authors.initials: LF
authors.lastname: Fried
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
authors.forename: Stephen
authors.initials: S
authors.lastname: Seliger
authors.forename: Daniel
authors.initials: D
authors.lastname: Gillen
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: David
authors.initials: D
authors.lastname: Siscovick
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology*; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors