Combined Association of Albuminuria and Cystatin C–Based Estimated GFR With Mortality, Coronary Heart Disease, and Heart Failure Outcomes: The Atherosclerosis Risk in Communities (ARIC) Study
American Journal of Kidney Diseases,  Clinical Article

Waheed S et al. – Mildly decreased cystatin C–based estimated glomerular filtration rate (eGFRcys) and mild albuminuria independently contributed to the risk of mortality, Coronary Heart Disease (CHD), and heart failure. Even minimally decreased eGFRcys (75–89 mL/min/1.73 m2) is associated with increased risk in the presence of mild albuminuria. Combining the 2 markers is useful for improved risk stratification even in those without clinical chronic kidney disease (CKD).

Methods
  • Prospective cohort.
  • 10,403 ARIC (Atherosclerosis Risk in Communities) Study participants followed up for a median of 10.2 years.
  • Mortality, coronary heart disease (CHD), and heart failure, as well as a composite of any of these separate outcomes.

Results
  • Both decreased eGFRcys and albuminuria were associated independently with the composite outcome, as well as mortality, CHD, and heart failure.
  • Although eGFRcys of 75–89 mL/min/1.73 m2 in the absence of albuminuria (albumin–creatinine ratio [ACR] <10 mg/g) or albuminuria with ACR of 10–29 mg/g with normal eGFRcys (90–104 mL/min/1.73 m2) was not associated significantly with any outcome compared with eGFRcys of 90–104 mL/min/1.73 m2 and ACR <10 mg/g, the risk of each outcome was significantly higher in those with both eGFRcys of 75–89 mL/min/1.73 m2 and ACR of 10–29 mg/g (for mortality, HR of 1.4 [95% CI, 1.1–2.0]; for CHD, HR of 1.9 [95% CI, 1.4–2.6]; for heart failure, HR of 1.8 [95% CI, 1.2–2.7]).
  • Combining the 2 markers improved risk classification for all outcomes (P < 0.001), even in those without overt CKD.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: Insights from a qualitative substudy Menopause, November 10, 2014    Clinical Article

3 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

4 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

5 Effect of black tea intake on blood cholesterol concentrations in individuals with mild hypercholesterolemia: a diet-controlled randomized trial Journal of the Academy of Nutrition and Dietetics, November 11, 2014    Clinical Article

6 Consumption of garlic and risk of colorectal cancer: An updated meta-analysis of prospective studies Full Text World Journal of Gastroenterology, November 18, 2014    Free full text    Evidence Based Medicine

7 Fiber intake and risk of subsequent prostate cancer in Japanese men American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

8 Associations between the levels of sclerostin, phosphate, and fibroblast growth factor-23 and treatment with vitamin D in hemodialysis patients with low intact PTH level Osteoporosis International, November 10, 2014    Evidence Based Medicine

9 Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women Menopause, November 7, 2014    Clinical Article

10 Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

11 Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review Clinical Nutrition, November 21, 2014    Clinical Article

12 Fruit and vegetable intake and rate of heart failure: A population-based prospective cohort of women European Journal of Heart Failure, November 12, 2014    Clinical Article

13 Effect of low salt diet on insulin resistance in salt-sensitive versus salt-resistant hypertension Hypertension, November 26, 2014    Clinical Article

14 Systemic markers of collagen metabolism and vitamin C in smokers and non-smokers with pelvic organ prolapse European Journal of Obstetrics & Gynecology and Reproductive Biology, November 26, 2014    Clinical Article

15 High-fructose diet in adolescence may exacerbate depressive-like behavior Emory's Woodruff Health Sciences Center News, November 21, 2014

16 Association between fatty acid supplementation and prenatal stress in African Americans: A randomized controlled trial Obstetrics and Gynecology, November 26, 2014    Clinical Article

17 Vegetarian diets and glycemic control in diabetes: A systematic review and meta-analysis Full Text Cardiovascular Diagnosis and Therapy, November 20, 2014    Free full text    Evidence Based Medicine    Review Article

18 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

19 Association between sugar-sweetened beverages and type 2 diabetes: a meta-analysis Journal of Diabetes Investigation, November 13, 2014    Evidence Based Medicine    Review Article

20 Tomato juice consumption improves blood antioxidative biomarkers in overweight and obese females Clinical Nutrition, November 13, 2014    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore