Cardiovascular risk factor profiles and kidney function stage in the US general population: the NHANES III study

Mayo Clin Proc. 2005 Oct;80(10):1270-7. doi: 10.4065/80.10.1270.

Abstract

Objective: To determine the prevalence of cardiovascular risk factors in the general population based on kidney function.

Subjects and methods: We retrospectively analyzed data from the Third National Health and Nutrition Examination Survey of noninstitutionalized US adults, which was conducted from 1988 to 1994. Data were gathered on 9 cardiovascular risk factors (smoking; obesity; hypertension; high total cholesterol, C-reactive protein, glycosylated hemoglobin, and homocysteine levels; low hemoglobin level; and high urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate (GFR).

Results: For the 15,837 subjects, the estimated GFR was at least 90 mL/min per 1.73 m2 (normal) in 65.4%, 60 to 89.9 mL/ min per 1.73 m2 (stage 2 kidney function) in 27.9%, 30 to 59.9 mL/min per 1.73 m2 (stage 3 kidney function) in 6.2%, and less than 30 mL/min per 1.73 m2 (stages 4 and 5 kidney function) In 0.5%. The number of cardiovascular risk factors Increased with stage of kidney dysfunction. Of subjects with a normal GFR, 30.4% had no risk factors, 34.9% had 1 risk factor, and 34.7% had 2 or more risk factors. Of subjects with stage 2 kidney function, 24.8% had no risk factors, 30.3% had 1 risk factor, and 44.9% had 2 or more risk factors. Of subjects with stage 3 kidney function, 1.4% had no risk factors, 14.9% had 1 risk factor, and 83.6% had 2 or more risk factors. All subjects with stages 4 and 5 kidney function had 2 or more risk factors. After covariate adjustment, odds ratios for having an estimated GFR lower than 60 mL/min per 1.73 m2 were 1, 3.7 (95% confidence interval, 1.2-11.3), and 10.4 (95% confidence interval, 3.9-27.8) times greater in subjects with 0, 1, and 2 or more cardiovascular risk factors, respectively (P<.001).

Conclusion: Persons with chronic kidney disease are much more likely to need multiple cardiovascular risk factor interventions than those without chronic kidney disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cardiovascular Diseases / epidemiology*
  • Cholesterol, LDL / blood*
  • Chronic Disease
  • Comorbidity
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / physiopathology*
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology

Substances

  • Cholesterol, LDL