Details

Autor(en) / Beteiligte

• Barr, Elizabeth LM
• Reutens, Anne
• Magliano, Dianna J
• Wolfe, Rory
• Lu, Zhong X
• Sikaris, Ken A
• Tanamas, Stephanie K
• Atkins, Robert
• Chadban, Steve
• Shaw, Jonathan E
• Polkinghorne, Kevan R

Titel

Cystatin C estimated glomerular filtration rate and all‐cause and cardiovascular disease mortality risk in the general population: AusDiab study

Ist Teil von

• Nephrology (Carlton, Vic.), 2017-03, Vol.22 (3), p.243-250

Ort / Verlag

Australia: Wiley Subscription Services, Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Aims Uncertainties about the role of cystatin C‐based estimated glomerular filtration rate (eGFR) in the prediction of cardiovascular disease (CVD) beyond traditional CVD risk factors remain. We assessed contributions of eGFR to CVD and mortality in the general population. Methods Using 14 year follow‐up data on 9353 adults without a reported history of CVD from the Australian Diabetes, Obesity and Lifestyle study, we assessed the contributions of eGFR (assessed by cystatin C (eGFRcysC) and serum creatinine (eGFRcr) and albuminuria (uACR) to total and CVD mortality. Results After adjusting for age, sex, CVD risk factors and uACR, compared with an eGFRcysC >90 mL/min per 1.73 m2, eGFRcysC <60 mL/min per 1.73 m2 was associated with 56% and 73% increases in the risks for all‐cause and CVD mortality, respectively. The respective changes for the c‐statistic when eGFRcysC was added to a risk prediction model were 0.003 (95% confidence interval: 0.001 to 0.005) and 0.002 (95% confidence interval: −0.001 to 0.006). The net proportion of non‐events assigned a lower‐risk category significantly improved with the addition of eGFR (non‐event net reclassification index eGFRcr: 1.0% and eGFRcysC: 1.5%) for all‐cause mortality, but for CVD mortality, improvements were only significant when eGFR was combined with uACR. The net proportion of events assigned a higher‐risk category was not significantly improved. Conclusion In our community‐based cohort, reduced eGFRcysC was associated with all‐cause and CVD mortality. The addition of chronic kidney disease measures to risk prediction models improved overall risk stratification among those at low risk as opposed to those at high baseline risk of mortality. Summary at a Glance In the community‐based study, Barr et al. provide additional supportive evidence that eGFR based on cystatin C may play an important role in the pathophysiology of CVD within the general population, as evidenced by the moderate associations observed with mortality from all‐causes and CVD.