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eGFR and albuminuria for prediction of cardiovascular outcomes

In the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study, chronic kidney disease was predictive of an increased risk of adverse outcomes in the intensively treated group compared with the standard group. But are creatinine-based estimated glomerular filtration rate (eGFR) and albuminuria predictive of cardiovascular events in the general population? Researchers have examined a cohort of 637,000 people with no history of cardiovascular disease, finding that both eGFR levels and albuminuria independently predicted cardiovascular disease.

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by Colin Kenny, GP, Dromore

 

Researchers conducted a meta-analysis of 637,315 individuals without a history of cardiovascular disease included in the Chronic Kidney Disease Prognosis Consortium. They wanted to assess what predicted cardiovascular mortality, fatal and non-fatal cases of coronary heart disease, stroke and heart failure over a 5-year timeframe. They assessed whether creatinine-based eGFR and albuminuria would predict cardiovascular risk as well as traditional risk factors.

The analysts found that both eGFR levels and albuminuria independently improved prediction of cardiovascular disease, especially heart failure and death from heart attack and stroke, with the presence of albuminuria the strongest predictor. These factors were more sensitive predictors for heart failure and death from heart attack and stroke than were cholesterol levels and systolic blood pressure.

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