Heart Risk Tool May Be Failing Kidney Patients

Widely used 'risk score' underestimates dangers to end-stage patients, study finds

SATURDAY, Nov. 18, 2006 (HealthDay News) -- The Framingham Score -- a standard tool for predicting cardiovascular disease -- greatly underestimates the actual rate of heart disease in patients receiving dialysis for end-stage renal (kidney) disease, a new report finds.

"This (underestimation) may lead to inadequate or delayed initiation of treatments to prevent CVD in a group of patients for whom heart disease is the main cause of death," study authors Dr. Darshan S. Dalal and Dr. Rulan S. Parekh, of Johns Hopkins University in Baltimore, said in a prepared statement.

They and their colleagues compared predicted and actual rates of heart disease in more than 4,200 patients with end-stage renal disease (ESRD).

They found that the Framingham Score greatly underestimated cardiovascular risk for men ages 30 to 75. The median estimated risk was 2.2 percent but the actual risk over an average of two years' follow-up was 35 percent.

Among women in the same age group, the median estimated risk of cardiovascular disease was 2 percent while the actual risk was 37 percent.

The findings suggest that for 60 percent of ESRD patients who are initially free of heart disease, their risk of cardiovascular illness is much higher than that predicted by the Framingham Score, the researchers said.

"Newer and more comprehensive risk equations are needed to assess and predict cardiovascular risk in ESRD patients," Dalal and Parekh said.

The study findings were presented Friday at the American Society of Nephrology's annual meeting in San Diego.

More information

The U.S. National Library of Medicine has more about ESRD.

SOURCE: American Society of Nephrology, news release, Nov. 17, 2006
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