2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2006101159v1 18/4/1307    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kottgen, A. Articles by Coresh, J. Search for Related Content PubMed PubMed Citation Articles by Kottgen, A. Articles by Coresh, J. Related Collections Related Article

Reduced Kidney Function as a Risk Factor for Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study

Anna Kottgen^*,, Stuart D. Russell, Laura R. Loehr, Ciprian M. Crainiceanu^||, Wayne D. Rosamond, Patricia P. Chang^,¶, Lloyd E. Chambless^** and Josef Coresh^*,,,||

Departments of ^* Epidemiology and ^|| Biostatistics, Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and Departments of Epidemiology, ^¶ Medicine, and ^** Biostatistics, University of North Carolina, Chapel Hill, North Carolina

Address correspondence to: Dr. Josef Coresh, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21287. Phone: 410-955-0495; Fax: 410-955-0476; E-mail: coresh{at}jhu.edu

Received for publication October 26, 2006. Accepted for publication January 31, 2007.

Reduced kidney function is a risk factor for cardiovascular morbidity and mortality, and both heart failure (HF) and kidney failure incidences are increasing. This study therefore sought to determine the effect of decreased kidney function on HF incidence in a population-based study of middle-aged adults. From 1987 through 2002, 14,857 participants of the Atherosclerosis Risk in Communities (ARIC) study who were free of prevalent HF at baseline were followed for incident HF hospitalization or death (International Classification of Diseases, Ninth Revision/10th Revision 428/I50). Estimated GFR (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease (MDRD) Study equation, and kidney function was categorized as normal (eGFR 90 ml/min per 1.73 m²; n = 7143), mildly reduced (eGFR 60 to 89 ml/min per 1.73 m²; n = 7311), and moderately/severely reduced (eGFR <60 ml/min per 1.73 m²; n = 403). Cox proportional hazards models were used to control for demographic and cardiovascular risk factors; analyses were stratified by the presence of coronary heart disease at baseline. During a mean follow-up of 13.2 yr, 1193 participants developed HF. The incidence of HF was three-fold higher for individuals with eGFR <60 ml/min per 1.73 m² compared to the reference group with eGFR 90 ml/min per 1.73 m² (18 versus 6 per 1000 person-years). The overall adjusted relative hazard of developing HF was 1.94 (1.49 to 2.53) for individuals with eGFR <60 ml/min per 1.73 m² compared to the reference group and was significantly increased for individuals with and without prevalent coronary heart disease at baseline. A substantially greater decline in kidney function occurred in individuals concomitant with HF hospitalization/death compared to those who did not develop HF. In summary, middle-aged adults with moderately/severely reduced kidney function are at high risk for developing HF.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2007 18: 1021-1022. [Full Text] [PDF]

This article has been cited by other articles:

				F. Pizzarelli, F. Lauretani, S. Bandinelli, G. B. Windham, A. M. Corsi, S. V. Giannelli, L. Ferrucci, and J. M. Guralnik Predictivity of survival according to different equations for estimating renal function in community-dwelling elderly subjects Nephrol. Dial. Transplant., November 6, 2008; (2008) gfn594v1. [Abstract] [Full Text] [PDF]

				N. Cheung, R. Klein, J. J. Wang, M. F. Cotch, A. F. M. Islam, B. E. K. Klein, M. Cushman, and T. Y. Wong Traditional and Novel Cardiovascular Risk Factors for Retinal Vein Occlusion: The Multiethnic Study of Atherosclerosis Invest. Ophthalmol. Vis. Sci., October 1, 2008; 49(10): 4297 - 4302. [Abstract] [Full Text] [PDF]

				A. Kottgen, S.-J. Hwang, E. Rampersaud, J. Coresh, K. E. North, J. S. Pankow, J. B. Meigs, J. C. Florez, A. Parsa, D. Levy, et al. TCF7L2 Variants Associate with CKD Progression and Renal Function in Population-Based Cohorts J. Am. Soc. Nephrol., October 1, 2008; 19(10): 1989 - 1999. [Abstract] [Full Text] [PDF]

				N. Cheung, J. J. Wang, S. L. Rogers, F. Brancati, R. Klein, A. R. Sharrett, T. Y. Wong, and for the ARIC (Atherosclerosis Risk In Communities) Diabetic retinopathy and risk of heart failure. J. Am. Coll. Cardiol., April 22, 2008; 51(16): 1573 - 1578. [Abstract] [Full Text] [PDF]

				P. Stenvinkel, J. J. Carrero, J. Axelsson, B. Lindholm, O. Heimburger, and Z. Massy Emerging Biomarkers for Evaluating Cardiovascular Risk in the Chronic Kidney Disease Patient: How Do New Pieces Fit into the Uremic Puzzle? Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 505 - 521. [Abstract] [Full Text] [PDF]

				A. Kazory and E. A. Ross Contemporary Trends in the Pharmacological and Extracorporeal Management of Heart Failure: A Nephrologic Perspective Circulation, February 19, 2008; 117(7): 975 - 983. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673