Abstract P312: Both Higher and Lower Estimated Glomerular Filtration Rates are Associated with Higher Risks of All-cause Death and Cardiovascular Mortality and Morbidity among Elderly Japanese People
Background: Reduced estimated glomerular filtration rates (eGFRs) and albuminuria contribute to higher risks for all-cause death and cardiovascular mortality and morbidity. Recent studies indicated that higher eGFR was also associated with an increased risk for all-cause death among middle-aged people. However, it has not been elucidated whether a higher eGFR is associated with a high risk for cardiovascular mortality and whether the association exists among elderly people.
Methods: A total of 6,824 male and female participants aged 70 years or older and whose eGFR less than 90 mL/min/1.73m2 were divided into four groups according to eGFR (estimated by CKDEPI equation, G1: 75 ≤ eGFR < 90; G2: 60 ≤ eGFR < 75; G3: 45 ≤ eGFR < 60; G4: eGFR <45 mL/min/1.73m2) and subdivided into eight groups by existence of albuminuria (urinary albumin creatinin ratio ≥ 30 mg/g). Main outcomes were all-cause death, cardiovascular death, malignant disease-related death and cardiovascular events (incident myocardial infarction or incident stroke). Sex- and age-adjusted mortality and incidence rates were estimated in the groups using Poisson’s regression analysis.
Results: A total of 541 participants died during the 5.5 year observation (37,555 person-years). The lowest mortality rate was found in G2. Higher eGFRs and lower eGFRs were associated with increased risks of all-cause death, and cardiovascular mortality and morbidity, especially with concomitant albuminuria. Association between risk of malignant disease-related death and eGFR was not observed. (See Table)
Conclusion: Both higher and lower estimated glomerular filtration rates were associated with higher risks of all-cause death and cardiovascular mortality and morbidity among elderly Japanese people, especially with concomitant albuminuria.
- © 2013 by American Heart Association, Inc.