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| Epidemiological evaluation of known and suspected cardiovascular risk factors in chronic renal impairment |
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| Author(s): Landray MJ, Thambyrajah J, McGlynn FJ, Jones HJ, Baigent C, Kendall MJ, Townend JN, Wheeler DC |
| Source: AMERICAN JOURNAL OF KIDNEY DISEASES Volume: 38 Issue: 3 Pages: 537-546 Published: SEP 2001 |
| Times Cited: 53 References: 28 |
| Abstract: Patients with chronic renal impairment (CRI) are at greatly increased risk for premature vascular disease; however, little is known about its evolution. This paper describes a cohort of patients with CRI and reports study design, baseline demographic and biochemical data, and comparisons with two contemporaneous age- and sex-matched control groups, one with established coronary artery disease and the other without overt vascular disease. Among 369 individuals (median age, 63 years; range, 18 to 88 years; 67% men) with CRI, 34% had a history of vascular disease and 21% had electrocardiographic left ventricular hypertrophy (LVH). Even in those with mild renal impairment (serum creatinine < 2.1 mg/dL), approximately one third had vascular disease and 12% had LVH. A history of hypertension was present in 76% of the CRI group, but as compared with controls, systolic and diastolic blood pressures were not elevated. Low-density lipoprotein (LDL) cholesterol concentration also was not elevated, but CRI was associated with elevated serum triglyceride and plasma homocysteine levels and reduced high-density lipoprotein (HDL) cholesterol, hemoglobin, and serum albumin concentrations. Across the spectrum of CRI, more severe renal dysfunction was associated with lower levels of diastolic blood pressure, LDL and HDL cholesterol, albumin, and hemoglobin, but increased levels of plasma homocysteine. This cross-sectional analysis shows that vascular disease is common in individuals with mild CRI attending a nephrology program and also suggests trends in the levels of a number of potential vascular risk factors with respect to severity of renal dysfunction. These results will be further quantified in a prospective biennial follow-up. (C) 2001 by the National Kidney Foundation, Inc. |
| Document Type: Article |
| Language: English |
| Reprint Address: Landray, MJ (reprint author), Radcliffe Infirm, Clin Trial Serv Unit, Hardness Bldg, Oxford OX2 6HE, England |
Addresses:
1. Radcliffe Infirm, Clin Trial Serv Unit, Oxford OX2 6HE, England
2. Univ Birmingham, Div Med Sci, Birmingham B15 2TT, W Midlands England
3. Univ Hosp Birmingham NHS Trust, Dept Nephrol, Birmingham, W Midlands England
4. Radcliffe Infirm, Epidemiol Studies Unit, Oxford OX2 6HE, England |
| Publisher: W B SAUNDERS CO, INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA |
| Subject Category: Urology & Nephrology |
| IDS Number: 469EY |
| ISSN: 0272-6386 |
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