Chronic Kidney Disease as a Risk Factor for Cardiovascular Disease and All-Cause Mortality: A Pooled Analysis of Community-Based Studies

摘要: Chronic kidney disease (CKD) is a major public health problem. Conflicting evidence exists among community-based studies as to whether CKD an independent risk factor for adverse cardiovascular outcomes. After subjects with baseline history of were excluded, data from four publicly available, longitudinal pooled: Atherosclerosis Risk in Communities Study, Cardiovascular Health Framingham Heart and Offspring Study. Serum creatinine levels indirectly calibrated across studies. was defined by GFR between 15 60 ml/min per 1.73 m(2). A composite myocardial infarction, fatal coronary heart disease, stroke, death the primary study outcome. Cox proportional hazards models used adjust study, demographic variables, educational status, other factors. The total population included 22,634 subjects; 18.4% black, 7.4% had CKD. There 3262 events. In adjusted analyses, outcome (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.07-1.32), there significant interaction function race. Black individuals HR 1.76 (95% CI, 1.35-2.31), whereas whites 1.13 1.02-1.26). all-cause mortality general more pronounced blacks than whites. It hypothesized that this effect may be due frequent or severe subclinical vascular secondary hypertension diabetes black individuals.