January 09, 2020
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Cardiovascular disease linked to increased risk for kidney failure

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Junichi Ishigami

Recently published research found major CVD events — including heart failure, atrial fibrillation, coronary heart disease and stroke — were associated with the development of ESRD. Heart failure was the strongest predictor of ESRD.

“Although it is broadly recognized that kidney disease increases the risk of cardiovascular disease, evidence on whether cardiovascular disease increases the long-term risk of end-stage renal disease has been sparse,” Junichi Ishigami, MD, PhD, assistant scientist in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, told Healio Nephrology. “Our study highlights the importance of protecting kidney health among individuals with cardiovascular disease, particularly heart failure.”

Using data from the Atherosclerosis Risk in Communities Study, researchers identified 9,047 patients with prevalent CVD. Patients were followed for a median of 17.5 years. During this time, 2,598 cases of hospitalization with CVD and 210 cases of incident ESKD occurred.

Researchers found the incidence of major CVD was associated with an increased risk for ESKD, with heart failure leading to a 11.4-times higher risk. Coronary heart disease, atrial fibrillation and stroke were also associated with an increased ESKD risk.

Ishigami argued that physicians must be aware that CVD is an important risk factor for ESRD and should aim to minimize nephrotoxic exposure (eg, NSAIDs and nephrotoxic antibiotics) for these patients.

“Our findings may have an implication on monitoring kidney function although current cardiovascular disease guidelines do not necessarily specify the frequency of evaluating kidney function following incidence of cardiovascular disease,” he said. “Further studies are needed to identify optimal strategies for preventing heart disease, but also for monitoring and managing kidney function post heart disease.” – by Melissa J. Webb

Disclosure: Ishigami reports no relevant financial disclosures.