title: Association of coronary artery disease and chronic kidney disease in Lebanese population.
abstract: BACKGROUND
  More evidence is emerging on the strong association between chronic kidney disease (CKD) and cardiovascular disease. We assessed the relationship between coronary artery disease (CAD) and renal dysfunction level (RDL) in a group of Lebanese patients.
  
  
  METHODS
  A total of 1268 patients undergoing cardiac catheterization were sequentially enrolled in a multicenter cross sectional study. Angiograms were reviewed and CAD severity scores (CADSS) were determined. Estimated glomerular filtration rate (eGFR) was calculated and clinical and laboratory data were obtained. CKD was defined as eGFR < 60 ml/min. Logistic regression model was performed using multivariate analysis including all traditional risk factors associated with both diseases. ANOVA and the Tukeytestswere used to compare subgroups of patients and to assess the impact of each disease on the severity of the other.
  
  
  RESULTS
  Among the 82% patients who exhibited variable degrees of CAD, 20.6% had an eGFR < 60 ml/min. Logistic regression analysis revealed a bidirectional independent association between CAD and CKD with an OR = 2.01 (P < 0.01) and an OR = 1.99 (P < 0.01) for CAD and CKD frequencies, respectively. We observed a steady increase in the CADSS mean as eGFR declined and a progressive reduction in renal function with the worsening of CAD (P < 0.05). This correlation remained highly significant despite considerable inter-patient variability and was at its highest at the most advanced stages of both diseases.
  
  
  CONCLUSIONS
  Our results show a strong, independent and graded bidirectional relationship between CAD severity and RDL. We propose to add CAD to the list of risk factors for the development and progression of CKD.
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Aline
authors.initials: A
authors.lastname: Milane
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Georges
authors.initials: G
authors.lastname: Khazen
authors.affiliation: School of Medicine, Lebanese University Beirut, Lebanon.
authors.forename: Nabil
authors.initials: N
authors.lastname: Zeineddine
authors.affiliation: School of Medicine, Lebanese University Beirut, Lebanon.
authors.forename: Mazen
authors.initials: M
authors.lastname: Amro
authors.affiliation: School of Medicine, Lebanese University Beirut, Lebanon.
authors.forename: Leila
authors.initials: L
authors.lastname: Masri
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Michella
authors.initials: M
authors.lastname: Ghassibe-Sabbagh
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Sonia
authors.initials: S
authors.lastname: Youhanna
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Angelique K
authors.initials: AK
authors.lastname: Salloum
authors.affiliation: The Wellcome Trust Centre for Human Genetics, University of Oxford Oxford, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Haber
authors.affiliation: Bioinformatics and Pattern Discovery, IBM T. J. Watson Research Centre New York, NY, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Platt
authors.affiliation: Department of Oncology, University of Oxford Roosevelt Drive, Oxford OX3 7DQ, UK.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Cazier
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Rafik Hariri University Hospital Beirut, Lebanon.
authors.forename: Raed
authors.initials: R
authors.lastname: Othman
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Rafik Hariri University Hospital Beirut, Lebanon.
authors.forename: Samer
authors.initials: S
authors.lastname: Kabbani
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Rafik Hariri University Hospital Beirut, Lebanon.
authors.forename: Hana
authors.initials: H
authors.lastname: Sbeite
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Chami
authors.affiliation: School of Medicine, Lebanese University Beirut, Lebanon.
authors.forename: Elie
authors.initials: E
authors.lastname: Chammas
authors.affiliation: Lebanese American University Beirut, Lebanon.
authors.forename: Hamid
authors.initials: H
authors.lastname: El Bayeh
authors.affiliation: INSERM UMRS1138, Cordeliers Research Centre, 15 rue de l'Ecole de Médecine 75006 Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Gauguier
authors.affiliation: Division of Cardiology, Department of Internal Medicine, American University of Beirut Beirut, Lebanon.
authors.forename: Antoine B
authors.initials: AB
authors.lastname: Abchee
authors.affiliation: Lebanese American University Beirut, Lebanon ; Harvard School of Public Health Boston, MA 02215, USA.
authors.forename: Pierre
authors.initials: P
authors.lastname: Zalloua
authors.affiliation: School of Medicine, Lebanese University Beirut, Lebanon ; Division of Nephrology, Department of Internal Medicine, Rafik Hariri University Hospital Beirut, Lebanon.
authors.forename: Antoine
authors.initials: A
authors.lastname: Barbari
keywords: Chronic kidney disease; Lebanese population; coronary artery disease