In:
Clinical Chemistry, Oxford University Press (OUP), Vol. 63, No. 4 ( 2017-04-01), p. 887-897
Abstract:
Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue. METHODS We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study. RESULTS After adjustment for potential confounders, eGFR and UAE were associated with these biomarkers of cardiac injury, even at levels that do not fulfill the CKD criteria. For example, eGFR 60– & lt;90 mL · min−1 ·(1.73 m2)−1 [vs ≥90 mL · min−1 · (1.73 m2)−1] was associated with a [ratio (95% CI)] 1.21 (1.17–1.26), 1.14 (1.07–1.20), and 1.19 (1.12–1.27) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively. The association of eGFR with hs-cTnT was statistically significantly stronger than that with hs-cTnI. In addition, UAE 15– & lt;30 mg/24 h (vs & lt;15 mg/24 h) was associated with a 1.04 (0.98–1.10), 1.08 (1.00–1.18), and 1.07 (0.96–1.18) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively. CONCLUSIONS eGFR and albuminuria were already associated with biomarkers of (subclinical) cardiac injury at levels that do not fulfill the CKD criteria. Although reduced renal elimination may partly underlie the associations of eGFR, these findings support the concept that eGFR and albuminuria are, over their entire range, associated with cardiac injury.
Type of Medium:
Online Resource
ISSN:
0009-9147
,
1530-8561
DOI:
10.1373/clinchem.2016.266031
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2017
Bookmarklink
