Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: Results from the atherosclerosis risk in communities study

Paul Muntner, Jiang He, Brad C. Astor, Aaron R. Folsom, Josef Coresh

Research output: Contribution to journalArticle

Abstract

Some risk factors for coronary heart disease (CHD) incidence in the general population are not associated with CHD incidence among patients with ESRD but have not been well characterized in chronic kidney disease (CKD). The association of several risk factors with CHD incidence was studied among participants with CKD in the population-based Atherosclerosis Risk in Communities (ARIC) Study. CHD risk factors and estimated GFR using serum creatinine were measured among 807 ARIC participants with CKD (estimated GFR between 15 and 59 ml/min per 1.73 m2). The incidence of CHD during 10.5 yr of follow-up was 6.3, 8.5, and 14.4 per 1000 person-years among ARIC participants with an estimated GFR of ≥90, 60 to 89, and 15 to 59 ml/min per 1.73 m2, respectively. After adjustment for age, race, gender, and ARIC field center, among those with CKD, the relative risk (95% confidence interval) of CHD was 1.65 (1.01 to 2.67) for current smoking, 2.02 (1.27 to 3.22) for hypertension, 3.06 (2.01 to 4.67) for diabetes, and 1.96 (1.14 to 3.36) for anemia. The comparably adjusted relative risks of CHD for each standard deviation higher total and HDL cholesterol were 1.50 (1.25 to 1.71) and 0.79 (0.62 to 1.01), respectively, and 1.38 (1.13 to 1.69), 1.24 (1.06 to 1.46), 0.65 (0.54 to 0.79), and 1.38 (1.19 to 1.59) for waist circumference, leukocyte count, serum albumin, and fibrinogen, respectively. CHD risk factors in the general population remain predictive among patients with CKD. Given the high risk for CHD among patients with CKD, control of these risk factors may have a substantial impact on their excess burden of CHD.

Original languageEnglish (US)
Pages (from-to)529-538
Number of pages10
JournalJournal of the American Society of Nephrology
Volume16
Issue number2
DOIs
StatePublished - 2005

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Chronic Renal Insufficiency
Coronary Disease
Atherosclerosis
Incidence
Population
Waist Circumference
Leukocyte Count
Serum Albumin
Fibrinogen
HDL Cholesterol
Chronic Kidney Failure
Anemia
Creatinine
Smoking
Confidence Intervals
Hypertension
Serum

ASJC Scopus subject areas

  • Nephrology

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Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease : Results from the atherosclerosis risk in communities study. / Muntner, Paul; He, Jiang; Astor, Brad C.; Folsom, Aaron R.; Coresh, Josef.

In: Journal of the American Society of Nephrology, Vol. 16, No. 2, 2005, p. 529-538.

Research output: Contribution to journalArticle

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abstract = "Some risk factors for coronary heart disease (CHD) incidence in the general population are not associated with CHD incidence among patients with ESRD but have not been well characterized in chronic kidney disease (CKD). The association of several risk factors with CHD incidence was studied among participants with CKD in the population-based Atherosclerosis Risk in Communities (ARIC) Study. CHD risk factors and estimated GFR using serum creatinine were measured among 807 ARIC participants with CKD (estimated GFR between 15 and 59 ml/min per 1.73 m2). The incidence of CHD during 10.5 yr of follow-up was 6.3, 8.5, and 14.4 per 1000 person-years among ARIC participants with an estimated GFR of ≥90, 60 to 89, and 15 to 59 ml/min per 1.73 m2, respectively. After adjustment for age, race, gender, and ARIC field center, among those with CKD, the relative risk (95{\%} confidence interval) of CHD was 1.65 (1.01 to 2.67) for current smoking, 2.02 (1.27 to 3.22) for hypertension, 3.06 (2.01 to 4.67) for diabetes, and 1.96 (1.14 to 3.36) for anemia. The comparably adjusted relative risks of CHD for each standard deviation higher total and HDL cholesterol were 1.50 (1.25 to 1.71) and 0.79 (0.62 to 1.01), respectively, and 1.38 (1.13 to 1.69), 1.24 (1.06 to 1.46), 0.65 (0.54 to 0.79), and 1.38 (1.19 to 1.59) for waist circumference, leukocyte count, serum albumin, and fibrinogen, respectively. CHD risk factors in the general population remain predictive among patients with CKD. Given the high risk for CHD among patients with CKD, control of these risk factors may have a substantial impact on their excess burden of CHD.",
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