Mild Renal Insufficiency Ups Cardiovascular Risk

Inflammatory, procoagulant and endothelial markers play a role

TUESDAY, Jan. 2 (HealthDay News) -- Mild-to-moderate renal insufficiency is associated with an increased risk of cardiovascular-related death, according to a prospective study of elderly men published in the December issue of the European Heart Journal.

Sasiwarang Goya Wannamethee, M.D., of the Royal Free and University College Medical School in London, U.K., and colleagues examined the association between renal function as measured by estimated glomerular filtration rate and cardiovascular mortality among 4,029 men, aged 60 to 79, who were followed for six years. During the study period, 304 men died of cardiovascular causes.

Risk of cardiovascular mortality increased with decreasing estimated glomerular filtration rate. This risk was elevated among men with an estimated glomerular filtration rate of less than 60 mL/min per 1.73 m2 (chronic kidney disease). Reduced estimated glomerular filtration rate was associated with many traditional cardiovascular risk factors as well as higher levels of inflammatory markers including interleukin-6 and C-reactive protein, endothelial biomarkers such as von Willebrand factor and tissue plasminogen activator, and activated coagulation markers including fibrin D-dimer and blood viscosity.

"Our study confirms previous findings of an association between mild impairment of renal function and cardiovascular mortality independent of traditional risk factors and extends previous findings by examining the contribution of inflammation, procoagulant markers, and markers of endothelial dysfunction to this relationship," the study authors conclude.

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