title: Impact of age on the association between CKD and the risk of future coronary events.
abstract: BACKGROUND
  Elucidation of the relationship between age, kidney function, and absolute coronary risk would facilitate efforts to promote chronic kidney disease (CKD) as a high-risk state for future vascular events and justify current recommendations for statin treatment in CKD.
  
  
  METHODS
  Population-based study.
  
  
  METHODS
  1,268,538 people with data for estimated glomerular filtration rate and albuminuria who were treated in a single Canadian province.
  
  
  METHODS
  CKD risk groups (G1, G2, G3a, G3b, and G4 had estimated glomerular filtration rate ≥90, 60-89.9, 45-59.9, 30-44.9, and 15-29.9 mL/min/1.73 m2, respectively; A1, A2, and A3 had albuminuria with albumin-creatinine ratio [ACR]<30 mg/g or dipstick urinalysis negative, ACR of 30-300 mg/g or dipstick trace or 1+, and ACR >300 mg/g or dipstick ≥ 2+, respectively) and age (<40, 40-49, ≥50 years).
  
  
  RESULTS
  Rates of coronary death or nonfatal myocardial infarction (expressed per 1,000 person-years), stratified by age, sex, and CKD stage.
  
  
  METHODS
  The first available serum creatinine value and the corresponding date were set as the index serum creatinine value and index date, respectively. ACR or dipstick urinalysis data were obtained from the periods defined by 6 months before and after the index creatinine value.
  
  
  RESULTS
  Absolute rates of coronary death or nonfatal myocardial infarction were consistently greater than 10 per 1,000 person-years for people with CKD and 50 years or older, regardless of CKD stage. However, absolute rates of the composite outcome were consistently less than 10 per 1,000 person-years for those younger than 50 years.
  
  
  CONCLUSIONS
  Single Canadian province, median follow-up only 4.0 years.
  
  
  CONCLUSIONS
  People with CKD who are 50 years or older should be considered at the highest risk of coronary events. In contrast, consideration of other risk factors will be required when assessing future risk among people with CKD who are younger than 50 years.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada; Department of Public Health Sciences, University of Alberta, Edmonton, Canada. Electronic address: mtonelli-admin@med.ualberta.ca.
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama, Birmingham, AL.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Anita
authors.initials: A
authors.lastname: Lloyd
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada.
authors.forename: Braden
authors.initials: B
authors.lastname: Manns
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada; Department of Public Health Sciences, University of Alberta, Edmonton, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Neesh
authors.initials: N
authors.lastname: Pannu
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: James
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Canada.
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Coronary heart disease (CHD); chronic kidney disease (CKD); coronary risk; epidemiological study; future coronary events; nonfatal myocardial infarction (MI); statin treatment