Faculty Collaboration Database

Chronic kidney disease is associated with angiographic coronary artery disease. Am J Nephrol 2008;28(2):354-60

Date

11/30/2007

Pubmed ID

18046083

DOI

10.1159/000111829

Scopus ID

2-s2.0-38349042470 (requires institutional sign-in at Scopus site)   92 Citations

Abstract

BACKGROUND/AIMS: Patients with chronic kidney disease (CKD) have a dramatically increased risk for cardiovascular mortality. Few prior studies have examined the independent association of CKD with coronary anatomy.

METHODS: We evaluated the relationship between CKD and severe coronary artery disease (CAD) in 261 male veterans with nuclear perfusion imaging tests suggesting coronary ischemia. We used chart review and patient and provider interviews to collect demographics, clinical characteristics, and coronary anatomy results. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, based on the creatinine obtained prior to angiography. We defined significant coronary obstruction as at least one 70% or greater stenosis. We used logistic regression to determine whether CKD was independently associated with significant coronary obstruction.

RESULTS: The likelihood of CAD increased monotonically with decreasing eGFR, from 51% among patients with eGFR or = 90 ml/min/1.73 m2 to 84% in those with eGFR < 30 ml/min/1.73 m2 (p = 0.0046). Patients with CKD were more likely than those without CKD to have at least one significant coronary obstruction (75.9 vs. 60.7%, p = 0.016). Patients with CKD also had more significant CAD, that is, were more likely to have three-vessel and/or left main disease than those without CKD (34.9 vs. 16.9%, p = 0.0035). In logistic regression analysis, controlling for demographics and comorbidity, CKD continued to be independently associated with the presence of significant CAD (p = 0.0071).

CONCLUSION: CKD patients have a high prevalence of obstructive coronary disease, which may contribute to their high cardiovascular mortality.

Author List

Chonchol M, Whittle J, Desbien A, Orner MB, Petersen LA, Kressin NR

Author

Jeffrey Whittle MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Cohort Studies
Coronary Angiography
Coronary Artery Disease
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic
Kidney Function Tests
Male
Middle Aged
Multivariate Analysis
Nephrology