Estimated glomerular filtration rate, all-cause mortality and cardiovascular diseases incidence in a low risk population: the MATISS study

PLoS One. 2013 Oct 16;8(10):e78475. doi: 10.1371/journal.pone.0078475. eCollection 2013.

Abstract

Background: Chronic kidney disease (CKD) independently increases the risk of death and cardiovascular disease (CVD) in the general population. However, the relationship between estimated glomerular filtration rate (eGFR) and CVD/death risk in a general population at low risk of CVD has not been explored so far.

Design: Baseline and longitudinal data of 1465 men and 1459 women aged 35-74 years participating to the MATISS study, an Italian general population cohort, were used to evaluate the role of eGFR in the prediction of all-cause mortality and incident CVD.

Methods: Bio-bank stored sera were used to evaluate eGFR at baseline. Serum creatinine was measured on thawed samples by means of an IDMS-calibrated enzymatic method. eGFR was calculated by the CKD-EPI formula.

Results: At baseline, less than 2% of enrolled persons had eGFR < 60 mL/min/1.73 m(2) and more than 70% had a 10-year cardiovascular risk score < 10%. In people 60 or more years old, the first and the last eGFR quintiles (<90 and ≥109 mL/min/1.73 m(2), respectively) were associated to an increased risk for both all-cause mortality (hazard ratio 1.6, 95% confidence interval 1.2-2.1 and 4.3, 1.6-11.7, respectively) and incident CVD (1.6, 1.0-2.4 and 7.0, 2.2-22.9, respectively), even if adjusted for classical risk factors.

Conclusions: These findings strongly suggest that in an elderly, general population at low risk of CVD and low prevalence of reduced renal filtration, even a modest eGFR reduction is related to all-cause mortality and CVD incidence, underlying the potential benefit to this population of considering eGFR for their risk prediction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / physiopathology*
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models

Grant support

The MATISS Study is part of the CUORE Project - Epidemiology and Prevention of Cardiovascular Disease, funded by the Italian Ministry of Health and coordinated by the National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanita, Rome, Italy. This study was also partially funded by a grant by SYSKID (System Biology towards novel understanding of CKD diagnosis and treatment). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.