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Open Access Research article

“Association between moderate renal insufficiency and cardiovascular events in a general population: Tehran lipid and glucose study”

Farhad Hosseinpanah14*, Maryam Barzin1, Hosein Aghayan Golkashani1, Amir A Nassiri1, Farhad Sheikholeslami2 and Fereidoun Azizi3

Author Affiliations

1 Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Director, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran

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BMC Nephrology 2012, 13:59  doi:10.1186/1471-2369-13-59

Published: 16 July 2012

Abstract

Background

Chronic kidney disease(CKD) has been proposed as a risk factor for cardiovascular disease (CVD). There is conflicting evidence among community based studies regarding the association between CKD and CVD. Furthermore, in order to assess the possible interaction between CKD and BMI, we also examined the association between CKD and CVD, across different BMI categories.

Methods

The risk of CVD events was evaluated in a large cohort of participants selected from the Tehran Lipid and Glucose Study. Participants(mean age, 47.4 years) free of previous CVD were followed up for 9.1 years. GFR ml/min per 1.73 m2 was estimated using the MDRD formula.

Results

Of the 6,209 participants, 22.2%(1381) had CKD with eGFR ml/min per 1.73 m2 <60 at baseline. Almost all of them (99%) were in stage 3a. Moderate renal insufficiency only predicted CVD outcomes independently when we adjusted for age and sex. After further adjustment, the presence of moderate CKD lost its statistical significance to confer an independent increased risk of CVD events with a hazard ratio of: HR: 1.14, CI 95% 0.91-1.42. Furthermore, when participants were categorized according to CKD status and BMI groups, after further adjustment, no interaction was found(P = 0.2).

Conclusion

CKD was not an independent risk factor for CVD events in a community-based study in a Tehranian population and the higher prevalence of CVD in subjects with mild to moderate renal insufficiency might be due to the co-occurrence of traditional CVD risk factors in this group.

Keywords:
Chronic kidney disease; Cardiovascular disease; Body mass index; Glomerular filtration rate; General population