Declining Kidney Function Linked to Higher Cardiovascular Death Risk in Elderly Asians: Study Finds
Taiwan: A study published in BMJ Open has highlighted a significant link between declining kidney function and an increased risk of cardiovascular mortality in elderly individuals. Conducted by Ying-Jhen Huang and colleagues from the Research Center for Humanities and Social Sciences at Academia Sinica, Taipei, Taiwan, the research highlights the importance of routine kidney function monitoring as a potential tool for predicting cardiovascular risk in aging populations.
The retrospective cohort study analyzed data from a large community-based health examination database in Taipei City. Initially, the dataset comprised 315,045 health check-up visits of 97,803 individuals aged 65 years and older between 2005 and 2012. After excluding outliers and incomplete data, 64,732 elderly participants with at least two visits were included for further evaluation. Kidney function was assessed using estimated glomerular filtration rate (eGFR) and urine protein levels, while cardiovascular mortality data were extracted from the death registry.
The study revealed the following findings:
- During the study, 1,264 participants died from cardiovascular causes, with 4,055 prior health check-up records analyzed.
- A strong and independent association was observed between impaired kidney function and cardiovascular mortality.
- Elderly individuals with eGFR below 60 mL/min/1.73 m² had significantly higher risks, with hazard ratios reaching 3.98 in men and 6.77 in women when eGFR dropped below 45.
- Proteinuria was identified as a major predictor, with severe proteinuria increasing cardiovascular mortality risk more than fourfold in women and over twofold in men.
- A rapid decline in kidney function, defined as an annual decrease in eGFR of at least 5 mL/min/1.73 m², was independently linked to cardiovascular deaths.
- Men with rapid eGFR decline showed a hazard ratio of 3.24, while women exhibited a hazard ratio of 2.83.
- The combined presence of reduced eGFR and high urine protein levels significantly amplified cardiovascular mortality risk, highlighting the importance of evaluating both indicators together.
The authors emphasized that simple, routine health check-up indicators such as eGFR and urine protein can serve as early warning signs for cardiovascular mortality risk in elderly populations. They noted that the findings are particularly relevant for Asian populations, where research in this area has been limited. However, they also acknowledged certain limitations, including the use of urine test strips instead of the albumin-to-creatinine ratio for proteinuria assessment and the inability to generalize findings to all elderly Asian groups.
According to the researchers, integrating regular kidney function evaluation into routine geriatric care could help identify high-risk individuals and guide timely interventions to reduce cardiovascular mortality. The study highlights the interplay between renal and cardiovascular health, calling for closer monitoring of elderly patients to improve long-term outcomes.
Reference:
Huang Y, Hsu Y, Chuang Y, et alAssociation between renal function and cardiovascular mortality: a retrospective cohort study of elderly from health check-upBMJ Open 2021;11:e049307. doi: 10.1136/bmjopen-2021-049307
