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Associations of Newer Cardiac Risk Factors with Chronic Kidney Disease
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What is the problem and what is known about it so far?
Compared with people with healthy kidneys, people with chronic kidney disease have more cardiovascular complications, including heart attack and stroke. Traditional risk factors for cardiovascular disease include high blood pressure, diabetes, and abnormal cholesterol levels. Many people with chronic kidney disease have these traditional cardiovascular risk factors. More recently, researchers have identified other “newer” risk factors for cardiovascular disease. The newer risk factors include high blood levels of substances that indicate inflammation: homocysteine, C-reactive protein, and fibrinogen. The blood levels of specific fats are also newer risk factors: low levels of apolipoprotein A1 and high levels of apolipoprotein B or lipoprotein(a). The frequency of these newer cardiovascular risk factors in people with chronic kidney disease is unknown.
Why did the researchers do this particular study?
To examine the frequency of the newer cardiovascular risk factors in people with chronic kidney disease.
Who was studied?
Adults who participated in a national health study in the United States called the Third National Health and Nutrition Examination Survey.
How was the study done?
Using blood tests, the researchers divided people into 3 groups: normal kidneys, mild chronic kidney disease, or severe chronic kidney disease. They then compared the frequency of the newer risk factors among people in the 3 groups.
What did the researchers find?
Kidney disease was associated with lower apolipoprotein A1 levels and with higher levels of apolipoprotein B, apolipoprotein(a), fibrinogen, homocysteine, and C-reactive protein.
What were the limitations of the study?
This study cannot tell us whether these risk factors explain the higher rates of cardiovascular complications in people with chronic kidney disease. It also cannot tell us whether treating these risk factors can decrease cardiovascular complications in people with chronic kidney disease.
What are the implications of the study?
People with chronic kidney disease are more likely to have the newer cardiovascular risk factors than are people with healthy kidneys. Further research is necessary to learn whether changing these risk factors can help to prevent cardiovascular complications.
Article and Author Information
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The summary below is from the full report titled “The Prevalence of Nontraditional Risk Factors for Coronary Heart Disease in Patients with Chronic Kidney Disease.” It is in the 6 January 2004 issue of Annals of Internal Medicine (volume 140, pages 9-17). The authors are P. Muntner, L.L. Hamm, J.W. Kusek, J. Chen, P.K. Whelton, and J. He.
- Copyright ©2004 by the American College of Physicians
