Reduced Kidney Function Is Associated With Cardiometabolic Risk Factors, Prevalent and Predicted Risk of Cardiovascular Disease in Chinese Adults: Results From the REACTION Study

Lu, Jieli; Mu, Yiming; Su, Qing; Shi, Lixin; Liu, Chao; Zhao, Jiajun; Chen, Lulu; Li, Qiang; Yang, Tao; Yan, Li; Wan, Qin; Wu, Shengli; Liu, Yan; Wang, Guixia; Luo, Zuojie; Tang, Xulei; Chen, Gang; Huo, Yanan; Gao, Zhengnan; Ye, Zhen; Wang, Youmin; Qin, Guijun; Deng, Hongkui; Yu, Xuefeng; Shen, Feixia; Chen, Li; Zhao, Liebin; Sun, Jichao; Sun, Wanwan; Wang, Tiange; Du, Rui; Lin, Lin; Dai, Meng; Xu, Yu; Xu, Min; Bi, Yufang; Lai, Shenghan; Li, Donghui; Wang, Weiqing; Ning, Guang

doi:10.1161/jaha.116.003328

Cited by 29 publications

(25 citation statements)

References 43 publications

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“…This result is similar to recent studies which reported that subjects without renal dysfunction had a significantly higher cardiovascular risk (Jin et al, 2014;Wang et al, 2014;Ito et al, 2015;Lu et al, 2016). In a cohort study, an inverse correlation (R 2 = -0.291, p<0.01) was found in Japanese patients with obesity and type 2 diabetes without severe renal dysfunction (Ito et al, 2015).…”

Section: Discussionsupporting

confidence: 91%

“…In a Chinese population, a longitudinal study confirmed a significant inverse association between eGFR and FRS (R² = -0.669 in 2008, R² = -0.698 in 2011, p all <0.01) (Jin et al, 2014). Moreover, a significantly higher FRS was observed among Chinese age 40 years or old with mildly decreased eGFR (60-89 mL/min/1.73 m²) (Lu et al, 2016). However, there are conflicting findings from community-based studies on the association between mildly reduced eGFR and CVD, showing that eGFR is not independently associated with cardiovascular outcome in the general population (Smink et al, 2012).…”

Section: Discussionmentioning

confidence: 75%

“…The FRS allows physicians to estimate the individual 10-year cardiovascular risk by using traditional cardiac risk factors including gender, age, systolic blood pressure, hypertension treatment, diabetes mellitus history, total cholesterol, highdensity lipoprotein cholesterol (HDL-cholesterol) and cigarette smoking (D'Agostino et al, 2008). In addition to traditional cardiovascular risk factors, other factors, as kidney function, are under investigation in association with CVD (Jin et al, 2014;Wang et al, 2014;Lu et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Instead, eGFR is the most feasible clinical measure of kidney function (KDIGO, 2013). Some studies have demonstrated that reduced eGFR is a predictor of major cardiovascular events (Jin et al, 2014;Wang et al, 2014;Ito et al, 2015;Lu et al, 2016). Jin and contributors (2014) suggested that kidney function was also independently associated with CVD in a Chinese population without CKD (defined as eGFR <60 mL/min/1.73 m²), however their population was approximately 99% Han Yellow race, and conflicting conclusions may be obtained in different populations comprising subjects from other races.…”

Section: Introductionmentioning

confidence: 99%

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Association between kidney function and Framingham risk score in an admixed population of Brazil

Costa

Freitas

Cruz

et al. 2018

Braz. J. Pharm. Sci.

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Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk development. However, the mechanisms of reduced kidney function with CVD risk are unclear. This study aimed to investigate the association between kidney function and Framingham risk score (FRS) in participants with traditional cardiovascular risk factors and normal estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m² in an admixed population of Brazil. The participants were divided into three groups according to FRS: low risk group with 0% to <10%, moderate risk group with ≥10% to 20% and high risk group with >20%. The eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Data from participants were collected by questionnaire, and blood and urine samples were collected to analyze biochemical markers. A total of 214 subjects aged 53±10 years old was collected. There were 77 individuals in low risk group, 59 in moderate risk group and 78 in high-risk group. Mean eGFR CKD-EPI was 89.39±15.05 mL/min/1.73 m² and 90.74±16.17 mL/min/1.73 m 2 when race adjustment. The results indicated that there is an increasing the cardiovascular risk with a decreased of eGFR, conforming to a significant inverse correlation observed between eGFR and FRS with Spearman correlation (R²=-0.256, p<0.001; R²=-0.224, p=0.001, when adjusted for race). There was a statistically significant difference in eGFR CKD-EPI (p<0.001) and eGFR CKD-EPI with race adjustment (p=0.002) among risk groups. The data suggests that the reduction eGFR is associated with elevated FRS among Brazilian adults without CKD. Furthermore, the results suggest that race adjustment it's not necessary in Brazilian population.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between kidney function and Framingham risk score in an admixed population of Brazil

Costa

Freitas

Cruz

et al. 2018

Braz. J. Pharm. Sci.

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“…Left ventricular hypertrophy (LVH), one type of cardiac disease, emerges as an adaptive response to pressure or volume overload, appears to be a typical adverse cardiac remodeling that occurs in CKD patients with decreased eGFR [6]. Abnormal cardiac structure and function are increased the risk of cardiovascular morbidity and mortality [7].…”

Section: Introductionmentioning

confidence: 99%

Gender-specific association of decreased estimated glomerular filtration rate and left vertical geometry in the general population from rural Northeast China

Dai

Chen

et al. 2017

BMC Cardiovasc Disord

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BackgroundLeft ventricular hypertrophy (LVH) is common and associated with cardiovascular outcomes among patients with known chronic kidney disease (CKD). However, the link between decreased estimated glomerular filtration rate (eGFR) and left ventricular (LV) geometry remains poorly explored in general population. In this study, we examined the gender-specific association between eGFR and LVH in the general population from rural Northeast China.MethodsThis survey was conducted from July 2012 to August 2013. A total of 10907 participants (5,013 men and 5,894 women) from the rural Northeast China were randomly selected and examined. LV mass index (LVMI) was used to define LVH (LVMI > 46.7 g/m2.7 in women; > 49.2 g/m2.7 in men). LV geometry was defined as normal, or with concentric remodeling, eccentric or concentric hypertrophy, according to relative wall thickness (RWT) and LVMI. Mildly decreased eGFR was defined as eGFR ≥ 60 and < 90 ml/min/1.73 m2, and moderate-severely decreased eGFR was defined as eGFR < 60 ml/min/1.73 m2.ResultsAs eGFR decreased, LVH showed a gradual increase in the entire study population. Multivariate analysis revealed a gender-specific relationship between eGFR and LV geometry. Only in men, mildly decreased eGFR was associated with concentric remodeling [odds ratio (OR): =1.58; 95% CI: 1.14–2.20; P < 0.01] and concentric LVH OR = 1.63; 95% CI: 1.15–2.31; P < 0.01). And only in men, moderate-severely decreased eGFR was a risk factor for concentric LVH (OR = 4.56; 95% CI: 2.14–9.73; P < 0.001) after adjusting for confounding factors.ConclusionsThese findings suggested that decreased eGFR was a risk factor for LV geometry in men, and a gender-specific difference should be taken into account in clinical practice.

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Serum lipoprotein (a) is associated with increased risk of stroke in Chinese adults: A prospective study

Zhang¹,

Du²,

Peng³

et al. 2019

Atherosclerosis

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Reduced Kidney Function Is Associated With Cardiometabolic Risk Factors, Prevalent and Predicted Risk of Cardiovascular Disease in Chinese Adults: Results From the REACTION Study

Cited by 29 publications

References 43 publications

Association between kidney function and Framingham risk score in an admixed population of Brazil

Association between kidney function and Framingham risk score in an admixed population of Brazil

Gender-specific association of decreased estimated glomerular filtration rate and left vertical geometry in the general population from rural Northeast China

Serum lipoprotein (a) is associated with increased risk of stroke in Chinese adults: A prospective study

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