New research suggests that certain tests for measuring kidney health may be just as effective for assessing risk of heart disease as the more traditional cholesterol or blood pressure methods.
“People with chronic kidney disease are twice as likely to develop cardiovascular disease as those with healthy kidneys and roughly half of them die from it before they reach kidney failure,” according to a statement from Johns Hopkins University Bloomberg School of Public Health. “Several clinical guidelines already recommend that patients with diabetes, hypertension and the possibility of chronic kidney disease be evaluated for kidney function and kidney damage.”
To determine if common kidney function tests such as estimated glomerular filtration rate (eGFR) and albuminuria or albumin/creatinine ratio (ACR) could accurately predict cardiovascular disease, researchers from Johns Hopkins and other institutions analyzed data from 24 studies in the Chronic Kidney Disease Prognosis Consortium. The studies included nearly 640,000 participants with no prior history of heart disease.
Each of the ACR and eGFR tests were assessed to see if they could independently or together improve risk prediction for cardiovascular mortality, coronary disease, stroke, and heart
failure. Findings were published in the Lancet Diabetes & Endocrinology journal.
Each of the kidney function tests independently proved themselves as effective predictors of cardiovascular disease—particularly with respect to heart failure and death from heart attack and stroke.
ACR emerged as the more effective test, however, and was shown to outperform systolic blood pressure and cholesterol levels on measuring heart disease risk. “The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality,” according to the Lancet article.
“The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders,” the article stated.
The findings suggest that health care providers should be looking at kidney damage and kidney function data to better understand their patients’ risk of heart disease, said lead study author Kunihiro Matsushita, MD, PhD, an assistant scientist with the Bloomberg School's Department of Epidemiology, in the statement issued by Johns Hopkins Bloomberg School of Public Health.
“Cholesterol levels and blood pressure tests are good indicators of cardiovascular risk, but they are not perfect. This study tells us we could do even better with information that oftentimes we are already collecting,” Matsushita suggested.
The findings may assist doctors in making more prudent decisions about their patients’ diets and exercise regimens or making recommendations on cardiovascular disease prevention treatments such as statins.