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• W1487477061 abstract "Background:The cardiovascular risk implications of a combinedassessmentofreducedkidneyfunctionandmicroalbuminuria are unknown. In elderly persons, traditional cardiovascular risk factors are less predictive, and measures of end organ damage, such as kidney disease, maybeneededforimprovedcardiovascularmortalityrisk stratification. Methods: The glomerular filtration rate was estimated from calibrated serum creatinine, and the urine albumincreatinine ratio (ACR) was measured in 3 urine samples in 9709 participants of the second Nord-Trondelag Health Study (HUNT II), a Norwegian community-based health study, followed for 8.3 years with a 71% participation rate. Results:An estimated glomerular filtration rate (EGFR) at levels of less than 75 mL/min/1.73 m 2 was associated withhighercardiovascularmortalityrisk,whereasahigher ACRwasassociatedwithhigherriskwithnolowerlimit. Low EGFR and albuminuria were synergistic cardiovascularmortalityriskfactors.Comparedwithsubjectswith an EGFR greater than 75 mL/min/1.73 m 2 and ACR below the sex-specific median who were at the lowest risk, subjects with an EGFR of less than 45 mL/min/1.73 m 2 andmicroalbuminuriahadanadjustedincidencerateratio of 6.7 (95% confidence interval, 3.0-15.1; P.001). TheadditionofACRandEGFRimprovedtraditionalrisk models: 39% of subjects with intermediate risk were reclassifiedtolow-orhigh-riskcategorieswithcorrespondingobservedrisksthatwere3-folddifferentthantheoriginal category. Age-stratified analyses showed that EGFR and ACR were particularly strong risk factors for persons 70 years or older. Conclusions:Reduced kidney function and microalbuminuria are risk factors for cardiovascular death, independent of each other and traditional risk factors. The combined variable improved cardiovascular risk stratification at all age levels, but particularly in elderly persons where the predictive power of traditional risk factors is attenuated." @default.
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• W1487477061 date "2017-01-01" @default.
• W1487477061 modified "2023-09-22" @default.
• W1487477061 title "Association of Kidney Function and Albuminuria With Cardiovascular Mortality in Older vs Younger Individuals" @default.
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