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ABSTRACT: Objectives
This study aimed to investigate the relationship between cardiovascular mortality in elderly Asians and decline in renal function.Design
A retrospective cohort study.Setting
Community-based health examination database from Taipei city.Participants
At the beginning, the database included 315 045 health check-up visits of 97 803 elderly persons aged ≥65 years old from 2005 to 2012. After excluding missing values and outliers, there were 64 732 elderly persons with at least two visits retained for further analyses.Primary outcome measures
Kidney function indicators include estimated glomerular filtration rate (eGFR) and urine protein, and rapid decline in eGFR was defined as slope ≤ -5 mL/min/1.73 m2 per year. The endpoint outcome was defined as the cardiovascular deaths registered in the death registry encoded by the International Classification of Diseases. We applied a Cox proportional hazards model to analyse the association between renal function and cardiovascular mortality.Results
In this study, we found 1264 elderly persons died from cardiovascular diseases, for whom the data included 4055 previous health check-up visits. We observed significant and independent associations of eGFR <60 mL/min/1.73 m2 (HR (95% CI) of 60>eGFR≥45 and eGFR<45 in males: 2.85 (1.33 to 6.09) and 3.98 (1.84 to 8.61); in females: 3.66 (1.32 to 10.15) and 6.77 (2.41 to 18.99)), positive proteinuria (HR (95% CI) of +/-, +,++ and +++, ++++ in males: 1.51 (1.29 to 1.78) and 2.31 (1.51 to 3.53); in females: 1.93 (1.54 to 2.42) and 4.23 (2.34 to 7.65)) and rapid decline in eGFR (HR (95% CI) in males: 3.24 (2.73 to 3.85); in females: 2.83 (2.20 to 3.64) with higher risk of cardiovascular mortality. The joint effect of increased concentration of urine protein and reduced eGFR was associated with a higher risk of cardiovascular mortality.Conclusions
Renal function and rapid decline in renal function are independent risk factors for cardiovascular mortality in the elderly.
SUBMITTER: Huang YJ
PROVIDER: S-EPMC8458353 | biostudies-literature | 2021 Sep
REPOSITORIES: biostudies-literature
Huang Ying-Jhen YJ Hsu Yu-Lin YL Chuang Yung-Hsin YH Lin Hugo Y-H HY Chen Yen-Hsu YH Chan Ta-Chien TC
BMJ open 20210921 9
<h4>Objectives</h4>This study aimed to investigate the relationship between cardiovascular mortality in elderly Asians and decline in renal function.<h4>Design</h4>A retrospective cohort study.<h4>Setting</h4>Community-based health examination database from Taipei city.<h4>Participants</h4>At the beginning, the database included 315 045 health check-up visits of 97 803 elderly persons aged ≥65 years old from 2005 to 2012. After excluding missing values and outliers, there were 64 732 elderly per ...[more]