Impaired Renal Function Raises Risk of Advanced Coronary Atherosclerosis
Coronary atherosclerosis severity is significantly associated with decreased renal function, according to researchers.
A team led by Toshiaki Nakano, MD, PhD, of the Graduate School of Medical Sciences at Kyushu University in Fukuoka, Japan, studied autopsy findings from 126 elderly Japanese individuals. They examined the relationship between coronary atherosclerosis severity in three main coronary arteries and estimated glomerular filtration rate (eGFR).
The frequency of advanced atherosclerotic lesions increased with decreasing eGFR (in mL/min/1.73 m2), the authors reported in the American Journal of Kidney Diseases (2010;55:21-30). The frequency of these lesions was 33.6%, 41.7%, 52.3%, and 52.8% in patients with an eGFR of 60 or greater, 45-59, 30-44, and less than 30, respectively. Adjusting for potential confounders did not substantially change the relationship.
Compared with subjects who had an eGFR of 60 or higher, those with an eGFR of 45-59 had a 40% increased risk of having advanced atherosclerotic lesions. The risk was increased by twofold and threefold among individuals with an eGFR of 30-44 and below 30, respectively.
Subjects with an eGFR below 30 had a significant fourfold increased risk of having calcified lesions compared with individuals with an eGFR of 60 or higher.
Additionally, The presence of diabetes was associated with a 2.57 and 2.91 times increased risk of having advanced atherosclerosis and calcified lesions, respectively. The presence of hypertension was associated with a 76% and 88% increased risk, respectively.
“The findings emphasize that individuals with CKD should be considered a high-risk population for coronary heart disease, and cardiovascular risk factors should be monitored substantially in this population to prevent the progression of coronary atherosclerosis,” the authors concluded.