Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study
Objective To quantify associations of chronic kidney disease stages with major cardiovascular disease and non-vascular mortality in the general adult population. Design Prospective population based cohort study. Setting Reykjavik, Iceland. Participants 16 958 people aged 33-81 years without manifest...
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fthighwire:oai:open-archive.highwire.org:bmj:341/sep30_1/c4986 2023-05-15T16:52:16+02:00 Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study Di Angelantonio, Emanuele Chowdhury, Rajiv Sarwar, Nadeem Aspelund, Thor Danesh, John Gudnason, Vilmundur 2010-09-30 00:00:00.0 text/html http://www.bmj.com/cgi/content/short/341/sep30_1/c4986 https://doi.org/10.1136/bmj.c4986 en eng BMJ Publishing Group Ltd http://www.bmj.com/cgi/content/short/341/sep30_1/c4986 http://dx.doi.org/10.1136/bmj.c4986 Copyright (C) 2010, BMJ Publishing Group Ltd RESEARCH TEXT 2010 fthighwire https://doi.org/10.1136/bmj.c4986 2015-03-01T00:44:54Z Objective To quantify associations of chronic kidney disease stages with major cardiovascular disease and non-vascular mortality in the general adult population. Design Prospective population based cohort study. Setting Reykjavik, Iceland. Participants 16 958 people aged 33-81 years without manifest vascular disease and with available information on stage of chronic kidney disease (defined by both estimated glomerular filtration rate and urinary protein) at study entry. Main outcome measures Hazard ratios for time to major coronary heart disease outcomes and mortality. Results 1210 (7%) of participants had chronic kidney disease at entry. During a median follow-up of 24 years, 4010 coronary heart disease outcomes, 559 deaths from stroke, and 3875 deaths from non-vascular causes were recorded. Compared with the reference group (estimated glomerular filtration rate 75-89 ml/min/1.73 m2 and no proteinuria), people with lower renal function within the normal range of glomerular filtration rate did not have significantly higher risk of coronary heart disease. By contrast, in 1210 (7%) participants with chronic kidney disease at entry, hazard ratios for coronary heart disease, adjusted for several conventional cardiovascular risk factors, were 1.55 (95% confidence interval 1.02 to 2.35) for stage 1, 1.72 (1.30 to 2.24) for stage 2, 1.39 (1.22 to 1.58) for stage 3a, 1.90 (1.22 to 2.96) for stage 3b, and 4.29 (1.78 to 10.32) for stage 4. Information on chronic kidney disease increased discrimination and reclassification indices for coronary heart disease when added to conventional risk factors (P<0.01). The incremental gain provided by chronic kidney disease was lower than that provided by diabetes or smoking (C index increases of 0.0015, 0.0024, and 0.0124 respectively). Hazard ratios with chronic kidney disease were 0.97 (0.82 to 1.15) for cancer mortality and 1.26 (1.07 to 1.50) for other non-vascular mortality. Conclusions In people without manifest vascular disease, even the earliest stages of chronic kidney ... Text Iceland HighWire Press (Stanford University) BMJ 341 sep30 1 c4986 c4986 |
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RESEARCH Di Angelantonio, Emanuele Chowdhury, Rajiv Sarwar, Nadeem Aspelund, Thor Danesh, John Gudnason, Vilmundur Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
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RESEARCH |
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Objective To quantify associations of chronic kidney disease stages with major cardiovascular disease and non-vascular mortality in the general adult population. Design Prospective population based cohort study. Setting Reykjavik, Iceland. Participants 16 958 people aged 33-81 years without manifest vascular disease and with available information on stage of chronic kidney disease (defined by both estimated glomerular filtration rate and urinary protein) at study entry. Main outcome measures Hazard ratios for time to major coronary heart disease outcomes and mortality. Results 1210 (7%) of participants had chronic kidney disease at entry. During a median follow-up of 24 years, 4010 coronary heart disease outcomes, 559 deaths from stroke, and 3875 deaths from non-vascular causes were recorded. Compared with the reference group (estimated glomerular filtration rate 75-89 ml/min/1.73 m2 and no proteinuria), people with lower renal function within the normal range of glomerular filtration rate did not have significantly higher risk of coronary heart disease. By contrast, in 1210 (7%) participants with chronic kidney disease at entry, hazard ratios for coronary heart disease, adjusted for several conventional cardiovascular risk factors, were 1.55 (95% confidence interval 1.02 to 2.35) for stage 1, 1.72 (1.30 to 2.24) for stage 2, 1.39 (1.22 to 1.58) for stage 3a, 1.90 (1.22 to 2.96) for stage 3b, and 4.29 (1.78 to 10.32) for stage 4. Information on chronic kidney disease increased discrimination and reclassification indices for coronary heart disease when added to conventional risk factors (P<0.01). The incremental gain provided by chronic kidney disease was lower than that provided by diabetes or smoking (C index increases of 0.0015, 0.0024, and 0.0124 respectively). Hazard ratios with chronic kidney disease were 0.97 (0.82 to 1.15) for cancer mortality and 1.26 (1.07 to 1.50) for other non-vascular mortality. Conclusions In people without manifest vascular disease, even the earliest stages of chronic kidney ... |
format |
Text |
author |
Di Angelantonio, Emanuele Chowdhury, Rajiv Sarwar, Nadeem Aspelund, Thor Danesh, John Gudnason, Vilmundur |
author_facet |
Di Angelantonio, Emanuele Chowdhury, Rajiv Sarwar, Nadeem Aspelund, Thor Danesh, John Gudnason, Vilmundur |
author_sort |
Di Angelantonio, Emanuele |
title |
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
title_short |
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
title_full |
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
title_fullStr |
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
title_full_unstemmed |
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
title_sort |
chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study |
publisher |
BMJ Publishing Group Ltd |
publishDate |
2010 |
url |
http://www.bmj.com/cgi/content/short/341/sep30_1/c4986 https://doi.org/10.1136/bmj.c4986 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://www.bmj.com/cgi/content/short/341/sep30_1/c4986 http://dx.doi.org/10.1136/bmj.c4986 |
op_rights |
Copyright (C) 2010, BMJ Publishing Group Ltd |
op_doi |
https://doi.org/10.1136/bmj.c4986 |
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BMJ |
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341 |
container_issue |
sep30 1 |
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c4986 |
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c4986 |
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1766042418349604864 |