A Cystatin C-based glomerular filtration rate equation is a stronger predictor of cardiovascular mortality compared to creatinine-based equations

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Nerpin, ElisabetHögskolan Dalarna,Medicinsk vetenskap (författare)

A Cystatin C-based glomerular filtration rate equation is a stronger predictor of cardiovascular mortality compared to creatinine-based equations

Artikel/kapitelSvenska2010

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Göteborg,2010
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LIBRIS-ID:oai:dalea.du.se:5179
https://urn.kb.se/resolve?urn=urn:nbn:se:du-5179URI

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Språk:svenska
Sammanfattning på:svenska

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Background: Several prior studies report that decreased estimated glomerular filtration rate (eGFR) predicts cardiovascular disease in the general population, but this is less studied in a primary preventive setting. Currently, various methods are available to assess eGFR. In the present study, we aimed to evaluate different eGFR-equations (creatinine-based or cystatin C-based), for the prediction of cardiovascular death. Material and methods: In men without cardiovascular disease, participating in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM, n=649, mean age 71 years, median follow-up 12.9 years; 86 cardiovascular deaths during follow-up), eGFR was calculated from circulating creatinine by using the Modification of Diet in Renal Disease formula (eGFRMDRD) and the Chronic Kidney Disease Epidemiology Collaboration formula (eGFRCKD-EPI) and from circulating cystatin C using the following formula: 77.24x-1.2623 (eGFRcyst). Results: In Cox-proportional hazard models, 1-SD increase in eGFRcyst was associated with lower risk of cardiovascular mortality after adjustment for established cardiovascular risk factors and urinary albumin excretion rate (hazard ratio 0.74, 95% CI 0.59-0.92 (p=0.007). However, the creatinine-based GFR equations were not significantly associated with cardiovascular death (for eGFRMDRD: hazard ratio 0.84, 95% CI 0.67-1.06, (p=0.14), for eGFRCKD-EP : hazard ratio 0.86, 95% CI 0.69-1.07 (p=0.17)) in multivariable models. Moreover, when eGFRcyst was incorporated to a model with established risk factors, the integrated discrimination improvement was significantly increased 0.015, (p=0.02). Also eGFRcyst, provided improved discrimination beyond established risk factors and urinary albumine excretion rate (0.012, p=0.03). No improvement in integrated discrimination were seen with eGFRMDRD (p=0.25) or eGFRCKD-EPI (p=0.36). Conclusion: In our community-based cohort of elderly men free from cardiovascular disease at baseline, eGFRcyst significantly predicted cardiovascular death while the creatinine-based eGFR-equations did not. The fact that eGFRcyst improved model discrimination beyond established cardiovascular risk factors suggest that it may be a relevant risk marker for cardiovascular death in the elderly.

Ämnesord och genrebeteckningar

Cystatin C
Glomerular filtration rate
cardiovascular mortality
Nedsatt njurfunktion, insulinresistens, oxidativ stress och utvecklingen av hjärt-kärlsjukdomar

Biuppslag (personer, institutioner, konferenser, titlar ...)

Ingelsson, Erik (författare)
Riserus, Ulf (författare)
Sundström, Johan (författare)
Larsson, Anders (författare)
Hallan, Stein (författare)
Zethelius, Björn (författare)
Berglund, Lars (författare)
Basu, Samar (författare)
Ärnlöv, Johan (författare)
Högskolan DalarnaMedicinsk vetenskap (creator_code:org_t)

Sammanhörande titlar

Ingår i:Svenska Kardiovasculära vårmötetGöteborg

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https://urn.kb.se/resolve?urn=urn:nbn:se:du-5179

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Av författaren/redakt...: Nerpin, Elisabet; Ingelsson, Erik; Riserus, Ulf; Sundström, Johan; Larsson, Anders; Hallan, Stein; visa fler...; Zethelius, Björn; Berglund, Lars; Basu, Samar; Ärnlöv, Johan; visa färre...

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Av lärosätet: Högskolan Dalarna

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