Kidney function and the risk of cardiovascular disease

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b1307 (Published 29 June 2009) Cite this as: BMJ 2009;338:b1307
  1. Daniel E Weiner, assistant professor ,
  2. Dena E Rifkin, instructor
  1. 1Division of Nephrology, Tufts Medical Center, Boston, MA 02111, USA
  1. dweiner{at}tuftsmedicalcenter.org

    More accurate measures of kidney function are needed to identify those at risk

    Several studies have shown that people with impaired kidney function are at higher risk of cardiovascular disease and death,1 2 although the reasons for this are unclear. In the linked study (doi:10.1136/bmj.b2392), Kurth and colleagues examine data from female health professionals aged 45 and over enrolled in the Women’s Health Study (WHS) to assess the association of kidney function with cardiovascular disease and mortality.3

    The WHS is a randomised trial of low dose aspirin and vitamin E supplements conducted in nearly 40 000 relatively healthy, predominantly white, female healthcare professionals in the United States. Serum creatinine was assayed in 27 939 participants using a rate blanked method based on the Jaffé reaction, and estimated glomerular filtration rate (GFR) was calculated with the four-variable Modification of Diet in Renal Disease Study (MDRD) equation. Over a mean of 12 years, 1199 cardiovascular events and 856 deaths occurred. When compared with an estimated GFR >90 ml/min/1.73m2, the 1315 participants with an estimated GFR <60 ml/min/1.73m2 were not at increased risk of all cause …

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