title: Kidney function and sudden cardiac death in the community: The Atherosclerosis Risk in Communities (ARIC) Study.
abstract: Individuals with chronic kidney disease, particularly those requiring dialysis, are at high risk of sudden cardiac death (SCD). However, comprehensive data for the full spectrum of kidney function and SCD risk in the community are sparse. Furthermore, newly developed equations for estimated glomerular filtration rate (eGFR) and novel filtration markers might add further insight to the role of kidney function in SCD.
  
  
  
  We investigated the associations of baseline eGFRs using serum creatinine, cystatin C, or both (eGFRcr, eGFRcys, and eGFRcr-cys); cystatin C itself; and β2-microglobulin (B2M) with SCD (205 cases through 2001) among 13,070 black and white ARIC participants at baseline during 1990-1992 using Cox regression models accounting for potential confounders.
  
  
  
  Low eGFR was independently associated with SCD risk: for example, hazard ratio for eGFR <45 versus ≥90mL/(min 1.73m(2)) was 3.71 (95% CI 1.74-7.90) with eGFRcr, 5.40 (2.97-9.83) with eGFRcr-cys, and 5.24 (3.01-9.11) with eGFRcys. When eGFRcr and eGFRcys were included together in a single model, the association was only significant for eGFRcys. When three eGFRs, cystatin C, and B2M were divided into quartiles, B2M demonstrated the strongest association with SCD (hazard ratio for fourth quartile vs first quartile 3.48 (2.03-5.96) vs ≤2.7 for the other kidney markers).
  
  
  
  Kidney function was independently and robustly associated with SCD in the community, particularly when cystatin C or B2M was used. These results suggest the potential value of kidney function as a risk factor for SCD and the advantage of novel filtration markers over eGFRcr in this context.
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Takeki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Maryland, MD.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Agarwal
authors.affiliation: Division of Cardiology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Rajat
authors.initials: R
authors.lastname: Deo
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, Seattle, WA.
authors.forename: Nona
authors.initials: N
authors.lastname: Sotoodehnia
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Maryland, MD.
authors.forename: Morgan E
authors.initials: ME
authors.lastname: Grams
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Maryland, MD.
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.affiliation: Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC.
authors.forename: Wayne
authors.initials: W
authors.lastname: Rosamond
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Maryland, MD.
authors.forename: Gordon
authors.initials: G
authors.lastname: Tomaselli
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: kmatsush@jhsph.edu.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
mesh_terms: D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine