Chronic kidney disease stages 3-5 and cardiovascular disease in the veterans affairs population.
OBJECTIVE
Cardiovascular complications are common in patients with chronic kidney disease in the general population. The study aims to investigate the prevalence and prognosis of CKD stages 3-5 in the veterans affairs (VA) population, which is sicker with more co-morbid conditions.


METHODS
In this case-controlled study of 6,432 men the associations of risk factors with CKD and its risk of mortality were estimated using, primarily, logistic regression analysis.


RESULTS
The 1,045 (16.2%) patients with CKD stages 3-5 were older (72 +/- 10 vs. 59 +/- 13 years, P < 0.0001) with more hypertension (53.6 vs. 39.6%, P < 0.0001), diabetes (24.9 vs. 19.8%, P < 0.0002), and CVD (35.3 vs. 17.8%, P < 0.0001) at baseline. Age > or =65 years (odds ratio [95% CI]) (4.95 [4.22-5.82]), hypertension (1.56 [1.34-1.79]), diabetes mellitus (1.21 [1.03-1.43]), CVD (1.71 [1.47-2.00]), and White not Hispanic (1.57 [1.32-1.85]) were independently associated with CKD. The prevalence of CVD at baseline increased with decreasing renal function. Old age (1.98 [1.66-2.35]), CKD (1.94 [1.61-2.33], CVD (1.46 [1.23-1.74]) and tobacco use (1.91 [1.05-3.47]) were independently associated with the 750 (11.7%) deaths.


CONCLUSIONS
Among veterans, traditional cardiovascular risk factors, CVD, and CKD are highly prevalent. CKD is associated with increased risk of baseline CVD and follow-up mortality.
Banerjee
Debasish
D
Renal and Transplantation Unit, St. Georges Hospital NHS Trust, London, UK.
Contreras
Gabriel
G
Jaraba
Isabel
I
Carvalho
Decio
D
Ortega
Luis
L
Carvalho
Cristiane
C
Pezon
Candido
C
Rosenthal
Stephen P
SP
De La Rosa
Norman
N
Vemuri
Nuripama
N
Cherla
Gautam
G
Nahar
Nilay
N
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*