Korhonen PE, Kiiski S, Kautiainen H, Ojanen S, Tertti R. The Relationship of Kidney Function, Cardiovascular Morbidity, and All-Cause Mortality: a Prospective Primary Care Cohort Study.
J Gen Intern Med 2023;
38:1834-1842. [PMID:
36544069 PMCID:
PMC10271946 DOI:
10.1007/s11606-022-07885-8]
[Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND
Lower-than-normal estimated glomerular filtration rate (eGFR) is associated with the risk for all-cause mortality and adverse cardiovascular events. In this regard, the role of higher-than-normal eGFR is still controversial.
OBJECTIVE
Investigate long-term clinical consequences across the levels of eGFR calculated by the creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation among apparently healthy cardiovascular risk subjects.
DESIGN
Prospective study.
PARTICIPANTS
Participants (n=1747) of a population-based screening and intervention program for cardiovascular risk factors in Finland during the years 2005-2007.
MAIN MEASURES
Cardiovascular morbidity and all-cause mortality.
KEY RESULTS
Over the 14-year follow-up, subjects with eGFR ≥105 ml/min/1.73 m2 (n=97) had an increased risk for all-cause mortality [HR 2.15 (95% CI: 1.24-3.73)], incident peripheral artery disease [HR 2.62 (95% CI: 1.00-6.94)], and atrial fibrillation/flutter [HR 2.10 (95% CI: 1.21-3.65)] when compared to eGFR category 90-104 ml/min after adjustment for cardiovascular and lifestyle-related risk factors. The eGFR category ≥105 ml/min was also associated with a two-fold increased mortality rate compared to the Finnish general population.
CONCLUSIONS
Renal hyperfiltration defined as eGFR ≥105 ml/min/1.73 m2 is a frequent and important finding in patients commonly treated in primary care. These patients should be followed closely for timely interventions, such as strict BP and blood glucose regulation.
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