[Cardiovascular risk in patients with renal failure].
OBJECTIVE
Patients with renal failure (RF) have an increased risk of cardiovascular events. The aims of the present study were: a) to evaluate if RF is an independent cardiovascular risk factor, and b) to analyze the predictive capacity of the original Framingham and REGICOR functions charts in patients with RF.


METHODS
A total of 912 patients between 35-74 years old (average: 55.7 years; 56.4% female) with no evidence of cardiovascular disease, were included in the present study. The RF was defined in patients with a glomerular filtration < 60 ml/min (estimated with the equation of Cockroft-Gaukt).


RESULTS
13.5% of the patients presented RF criteria. The final rate of cardiovascular events was higher in the population with RF (21.1% vs 12.0%; p < 0.01; relative risk = 1.76; 95% confidence interval [CI], 1.19-2.59). Statistically significant differences were not found between men and women. The multiple logistic regression analysis showed that cigarette smoking (odds ratio [OR] = 2.17; 95% CI, 1.38-3.35), diabetes (OR = 2.08; 95% CI, 1.37-3.15), RF (OR = 1.83; 95% CI, 1.10-3.06), antihypertensive treatment (OR = 2.03; IC del 95%, 1.32-3.11), and hypertension (OR = 2.06; 95% CI, 1.06-4.05) were important factors for the prediction of coronary and cardiovascular events. The original Framingham function predicted suitably the coronary risk in the population with RF (18.3% versus 17.9%; p = 0.869) whereas REGICOR underestimated it (7.5% versus 17.9%; p < 0.05). The area under the receiver operator characteristic (ROC) curve obtained with the original Framingham function was similar to that of REGICOR function: 0.61 (95% CI, 0.47-0.75) and 0.62 (95% CI, 0.48-0.76), respectively.


CONCLUSIONS
The RF behaves like an important cardiovascular risk factor. The area under ROC curve obtained with the original Framingham function was similar to that of REGICOR function.
Calvo Hueros
Juan Ignacio
JI
Unidad Docente de Medicina Familiar y Comunitaria, Centro de Salud Universitario La Paz, Badajoz, España.
Cañón Barroso
Lourdes
L
Gómez Jiménez
Cristina
C
Martín Hidalgo-Barquero
María Victoria
MV
Espigares Arroyo
Manuel
M
Buitrago Ramírez
Francisco
F
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data