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Kidney disease raises risk of death

Even mild kidney disease can lead to an increased risk of death and cardiovascular disease.

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Even mild kidney disease can lead to an increased risk of death and cardiovascular disease. This reinforces the importance of early detection of chronic kidney disease, not only to slow the progression to end-stage kidney disease but also to identify risk factors for cardiovascular disease.Researchers form the Brigham and Women's Hospital in Boston, USA, assessed the effect of mild kidney disease on cardiovascular outcomes after a heart attack by analysing data from 14,527 patients. Compared with other subjects, those with a reduced glomerular filtration rate (GFR), – (a test used to assess kidney function), were found to have other risk factors and prior cardiovascular disease. Also, such subjects were less likely to be on drugs to prevent another heart attack or to undergo heart surgery. The estimated GFR was inversely related to the risk of death as well as the combined outcome of death from cardiovascular causes, congestive heart failure, another heart attack, stroke, or need for resuscitation after cardiac arrest. Most of the illness seen with a falling GFR was not kidney disease, but cardiovascular disease, according to the researchers.In another study, researchers from the Northern California in Oakland, USA, assessed the impact of mild kidney disease among more than 1 million adults. The average follow-up period was 2.84 years. The team found that the risk of death increased as the GFR dropped. A mildly decreased GFR raised the risk of death by 20 percent, whereas a severely low GFR increased the risk nearly six-fold. The risk of cardiovascular events and hospitalisation also rose as the glomerular filtration rate fell.The above studies strengthen the link between chronic kidney disease and cardiovascular disease.
The New England Journal of Medicine,
September 2004

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