January 1, 2006Circulation JournalOpen Access

Chronic Kidney Disease is a Risk Factor for Cardiovascular Death in a Community-Based Population in Japan

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular death (n=7316). Intervention: Chronic kidney disease (GFR <60 ml/min per 1.73 m2) vs. Normal kidney function (GFR ≥60 ml/min per 1.73 m2). Primary outcome: Cardiovascular death (HR 1.20, 95% CI 0.82-1.76).

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Key result

Chronic kidney disease (GFR <60) was associated with an increased risk of cardiovascular death (HR 1.20), with a graded increase in risk observed at progressively lower GFR levels (HR 9.12 for GFR <15).

Why the study?

Does chronic kidney disease increase the risk of cardiovascular death in a community-based population?

Population

7,316 community residents free of previous cardiovascular disease from 300 randomly selected districts in…

Comparison

Chronic kidney disease, defined as an estimated… vs Normal kidney function or GFR ≥60 ml/min per…

Design

Cohort

Follow-up

10 years

Authors

KNKoshi NakamuraHokkaido University TOTomonori OkamuraPreventive Cardiology THTakehito HayakawaRitsumeikan University

Discussion

Member takes

Implication

Supports GFR-based CV risk stratification in community cohorts; extends graded-risk data but leaves causal effects open for trials.

Study Design

Type

Cohort (n=7,316)

Multicenter

Yes

Structured PICO

Does chronic kidney disease increase the risk of cardiovascular death in a community-based population?

Population

7,316 community-dwelling Japanese adults aged 30 and older, free of previous cardiovascular disease, followed for 10 years.

Exposure

Chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (GFR) <60 ml/min per 1.73m².

Comparator

Normal kidney function (GFR ≥90 ml/min per 1.73m²) or GFR ≥60 ml/min per 1.73m².

Outcome

Cardiovascular death over 10 years of follow-up.hard clinical

Main Result

Hazard Ratio: 1.2 (95% CI 0.82–1.76)

Chronic kidney disease is an independent risk factor for cardiovascular death in the general Japanese population, demonstrating a graded increase in mortality risk as kidney function declines.

Limitations

GFR was estimated using simplified prediction equations, and for the abbreviated MDRD equation, Japanese participants were regarded as white.
Classification of participants was based only on baseline GFR, without accounting for changes during the 10-year follow-up.
Details of medication status, such as the use of angiotensin-converting enzyme inhibitors, were not available.
GFR was estimated using simplified prediction equations, and the MDRD equation includes a race term where Japanese were regarded as white.
Details of medication status (e.g., use of ACE inhibitors) were not available.

Cite This Study

Nakamura et al. (2006) conducted a cohort in Cardiovascular death (n=7,316). Chronic kidney disease (GFR <60 ml/min per 1.73 m2) vs. Normal kidney function (GFR ≥60 ml/min per 1.73 m2) was evaluated on Cardiovascular death (HR 1.20, 95% CI 0.82-1.76). Chronic kidney disease (GFR <60) was associated with an increased risk of cardiovascular death (HR 1.20), with a graded increase in risk observed at progressively lower GFR levels (HR 9.12 for GFR <15).

synapsesocial.com/papers/6a903e96fecd36257390a3bf https://doi.org/10.1253/circj.70.954

Topics

Women and heart disease

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Chronic Kidney Disease is a Risk Factor for Cardiovascular Death in a Community-Based Population in Japan

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Chronic Kidney Disease is a Risk Factor for Cardiovascular Death in a Community-Based Population in Japan

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider