Prediction of cardiovascular disease mortality by proteinuria and reduced kidney function: Pooled analysis of 39,000 individuals from 7 cohort studies in Japan

Masaharu Nagata, Toshiharu Ninomiya, Yutaka Kiyohara, Yoshitaka Murakami, Fujiko Irie, Toshimi Sairenchi, Katsuyuki Miura, Tomonori Okamura, Hirotsugu Ueshima

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

There are limited studies addressing whether proteinuria and estimated glomerular filtration rate (eGFR) are independently associated with cardiovascular disease in Asia. Using data from 7 prospective cohorts recruited between 1980 and 1994 in Japan, we assessed the influence of proteinuria (≥1+ on dipstick) and reduced eGFR on the risk of cardiovascular disease mortality in 39,405 participants (40-89 years) without kidney failure. During a 10.1-year follow-up, 1,927 subjects died from cardiovascular disease. Proteinuria was associated with a 1.75-fold (95% confidence interval (CI): 1.44, 2.11) increased risk of cardiovascular disease mortality after adjustment for potential confounding factors. Additionally, the multivariate-adjusted hazard ratio of cardiovascular disease mortality increased linearly with lower eGFR levels (Ptrend < 0.001): Subjects with eGFR of <45 mL/minute/1.73 m2 had a 2.22-fold (95% CI: 1.60, 3.07) greater risk of cardiovascular disease mortality than those with eGFR of ≥90 mL/minute/1.73 m2. Subjects with both proteinuria and eGFR of <45 mL/minute/1.73 m2 had a 4.05-fold (95% CI: 2.55, 6.43) higher risk of cardiovascular disease mortality compared with those with neither of these risk factors. There was no evidence of interaction in the relationship between proteinuria and lower eGFR (Pinteraction = 0.77). The present results suggest that proteinuria and lower eGFR are independent risk factors for cardiovascular disease mortality in the Japanese population.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalAmerican Journal of Epidemiology
Volume178
Issue number1
DOIs
Publication statusPublished - 2013 Jul 1

Keywords

  • cardiovascular disease
  • coronary artery disease
  • meta-analysis
  • proteinuria
  • renal insufficiency

ASJC Scopus subject areas

  • Epidemiology

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