Association between moderate renal insufficiency and cardiovascular events in a general population: Tehran lipid and glucose study.
BACKGROUND
Chronic kidney disease(CKD) has been proposed as a risk factor for cardiovascular disease (CVD). There is conflicting evidence among community based studies regarding the association between CKD and CVD. Furthermore, in order to assess the possible interaction between CKD and BMI, we also examined the association between CKD and CVD, across different BMI categories.


METHODS
The risk of CVD events was evaluated in a large cohort of participants selected from the Tehran Lipid and Glucose Study. Participants(mean age, 47.4 years) free of previous CVD were followed up for 9.1 years. GFR ml/min per 1.73 m(2) was estimated using the MDRD formula.


RESULTS
Of the 6,209 participants, 22.2%(1381) had CKD with eGFR ml/min per 1.73 m(2) <60 at baseline. Almost all of them (99%) were in stage 3a. Moderate renal insufficiency only predicted CVD outcomes independently when we adjusted for age and sex. After further adjustment, the presence of moderate CKD lost its statistical significance to confer an independent increased risk of CVD events with a hazard ratio of: HR: 1.14, CI 95% 0.91-1.42. Furthermore, when participants were categorized according to CKD status and BMI groups, after further adjustment, no interaction was found(P = 0.2).


CONCLUSIONS
CKD was not an independent risk factor for CVD events in a community-based study in a Tehranian population and the higher prevalence of CVD in subjects with mild to moderate renal insufficiency might be due to the co-occurrence of traditional CVD risk factors in this group.
Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. fhospanah@endocrine.ac.ir
Farhad
F
Hosseinpanah
Maryam
M
Barzin
Hosein Aghayan
HA
Golkashani
Amir A
AA
Nassiri
Farhad
F
Sheikholeslami
Fereidoun
F
Azizi
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007492:Iran; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors
D001786:Blood Glucose; D008055:Lipids