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Change in cardiovascular risk factors with progression of kidney disease.

TitleChange in cardiovascular risk factors with progression of kidney disease.
Publication TypeJournal Article
Year of Publication2009
AuthorsFried, LF, Katz, R, Cushman, M, Sarnak, M, Shlipak, MG, Kuller, L, Newman, AB
JournalAm J Nephrol
Volume29
Issue4
Pagination334-41
Date Published2009
ISSN1421-9670
KeywordsAged, Aged, 80 and over, Biomarkers, C-Reactive Protein, Cholesterol, HDL, Creatinine, Diabetes Mellitus, Factor VIII, Female, Follow-Up Studies, Humans, Hypertension, Renal, Interleukin-6, Logistic Models, Male, Prevalence, Renal Insufficiency, Chronic, Risk Factors, Vasculitis
Abstract<p><b>BACKGROUND: </b>Prior studies evaluating the relationship of kidney disease with cardiovascular risk factors have been limited by their cross-sectional design. We evaluated the change in lipids, inflammatory and procoagulant biomarkers with decline in kidney function in a nested case-cohort study in the Cardiovascular Health Study, a community-based study of adults aged >65 years.</p><p><b>METHODS: </b>Individuals with an increase in serum creatinine >or=0.3 mg/dl (baseline to 3 years later, n = 207) were matched to controls of similar age, race, gender, diabetes and baseline serum creatinine, but whose change in creatinine was <0.3 mg/dl. Baseline and change in risk factors were analyzed with conditional logistic regression.</p><p><b>RESULTS: </b>Changes in C-reactive protein were similar. In contrast, cases had larger increases in fibrinogen (OR 1.38 per standard deviation, 95% confidence interval 1.08-1.76) and factor VIII [1.38 (1.10-1.72)] and larger decreases in HDL [OR 0.80 (0.64, 1.00)]. Change in interleukin-6 was greater in cases than controls, but this did not persist after multivariate adjustment. However, in linear regression, change in interleukin-6 was correlated with change in creatinine.</p><p><b>CONCLUSION: </b>Cardiovascular risk factors and kidney function may change concurrently. This could lead to an increased risk of cardiovascular disease as kidney function worsens.</p>
DOI10.1159/000166598
Alternate JournalAm J Nephrol
PubMed ID18948687
PubMed Central IDPMC2786019
Grant ListN01-HC-85085 / HC / NHLBI NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
N01-HC-85081 / HC / NHLBI NIH HHS / United States
N01 HC015103 / HC / NHLBI NIH HHS / United States
N01HC55222 / HL / NHLBI NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
N01-HC-85082 / HC / NHLBI NIH HHS / United States
N01 HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-85083 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
N01-HC-85080 / HC / NHLBI NIH HHS / United States
R01 AG027002 / AG / NIA NIH HHS / United States
N01HC75150 / HL / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States
N01 HC045133 / HC / NHLBI NIH HHS / United States
N01 HC035129 / HC / NHLBI NIH HHS / United States
N01-HC-85084 / HC / NHLBI NIH HHS / United States