Led by researchers from the Johns Hopkins Bloomberg School of Public Health, a study has shown that measuring function and damaged levels in kidneys is comparable to traditional blood pressure and cholesterol tests when it comes to predicting risks of heart failure and deaths due to strokes and heart attacks.
Published in the journal Lancet Diabetes and Endocrinology, the study points to the possibility of using kidney function as an additional tool to help doctors in making better decisions about the health of their patients, tapping into information already being collected anyway.
"Cholesterol levels and blood pressure tests are good indicators of cardiovascular risk, but they are not perfect," said Kunihiro Matsushita, M.D., Ph.D., lead author for the study, adding doctors can do better with the added information that tests on kidney function can offer.
There are two common tests for assessing kidney health. One checks for the estimated glomerular filtration rate (eGFR) of the kidneys, which refers to how well waste products are being filtered out, and the other measures how much albumin, a protein, is leaking out of kidneys and into the urine. Low eGFRs mean the kidneys are not functioning at optimum capacity, while the presence of a lot of albumin in urine is an indicator of potential kidney damage.
The researchers analyzed data taken from 24 studies involving over 637,000 subjects without cardiovascular disease history. According to the results of the study, both tests for eGFR and albumin independently improved predictions for cardiovascular disease in general as well as deaths and heart failures from strokes and heart attacks, however, testing for albuminaria yielded stronger predictions, outperforming systolic blood pressure and levels of cholesterol.
It is unclear what connection reduced kidney function has with cardiovascular disease, but Matsushita said that poor kidney function leads to fluid retention, too much of which can cause heart failure. Those with chronic kidney disease have twice the risk of developing cardiovascular disease and about half of patients will die from heart disease before reaching kidney failure.
The study received support from the National Institute of Diabetes and Digestive and Kidney Diseases from the National Institutes of Health and the U.S. National Kidney Foundation. Other authors who participated in the study include Josef Coresh, Johan Arnlov, Mark Woodward, Yingying Sang, David Warnock, John Chalmers, Mark Sarnak, Caroline Fox, Ron Gansevoort, Tazeen Jafar, Kentaro Yamashita, Simerjot K. Jassal, Kazumasa Yamagishi, Gijs W. D. Landman, Arjan van Zuilen, Jonathan Townend, Paul Roderick, Marcello Tonelli, Toshimi Sairenchi, Michael Shlipak, Ben Schottker and Anoop Shankar.
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