Chronic kidney disease patients could be at similar levels of coronary risk to those who have previously had heart attac

Patients suffering from chronic kidney disease could be at as high a risk of coronary heart disease as patients who have previously had a heart attack, according to an article published Online First in the Lancet.

While it has long been established that patients with chronic kidney disease are at higher risk of heart attacks, the new study is the first large-scale, long-term study to examine whether kidney disease should be considered to be equivalent to having previously suffered a , in terms of the risk of future coronary events.

Lead researcher Dr Marcello Tonelli of the University of Alberta, said: "Our research suggests that there is a strong case for considering chronic kidney disease to be a coronary equivalent, meaning that people with chronic kidney disease are at a comparable risk of coronary events to those who have previously had a heart attack. Chronic kidney disease patients have substantially higher rates of death from heart disease after a heart attack than the general population, which emphasises the potential value of preventing coronary events through drug treatment and . In fact, the rate of death from heart disease among people with chronic kidney disease was similar to or higher than the rate of death among people with – in whom the value of preventive treatments is well known."

The study examined records from almost 1.3 million patients in Canada, comparing the incidence of heart attacks and death in patients with chronic kidney disease, diabetes, at least one previous heart attack, or a combination of these risk factors. The researchers found that people with chronic kidney disease, diabetes, or both, tended to experience a comparable risk of heart attack to those who had previously had a heart attack, suggesting that kidney disease could prove to be a useful prognostic marker for .

The findings are important because patients identified as having a coronary heart disease risk equivalent can receive targeted treatment – for example, with drugs such as statins, which reduce the risk of due to their effects of lowering "bad" fats (lipids) in the bloodstream. In the UK, almost 9% of the are thought to suffer from chronic kidney disease, which often – but not always – accompanies diabetes, already thought of as a coronary heart disease risk equivalent.

In an accompanying Comment, George Bakris of The University of Chicago, urges caution in the interpretation of the results, suggesting that although the study's large scale is an advantage, a lack of information about individuals' medication and other factors such as blood pressure means that the findings don't necessarily provide clear-cut support for the classification of chronic kidney disease as a coronary heart disease risk equivalent.

However, even if further analysis fails to support the classification of chronic kidney disease as a coronary risk equivalent, the work is still likely to have important implications for coronary disease prevention strategies. As Professor Bakris states: "Tonelli and colleagues offer new insight by comparing individuals with chronic kidney disease with those who have a history of heart attack, on a very large scale. Their findings emphasise the importance of primary prevention, particularly because patients with comprise a large proportion of patients who have heart attack."

More information: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60572-8

add to favorites email to friend print save as pdf

Related Stories

Heart drug 'safe for kidney patients'

Jun 13, 2011

(Medical Xpress) -- The full results of a trial show that people with chronic kidney disease can reduce their heart risk by taking a combination drug that lowers levels of ‘bad’ cholesterol.

Recommended for you

Ebola reveals shortcomings of African solidarity

9 hours ago

As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

Second bird flu case confirmed in Canada

Jan 30, 2015

The husband of a Canadian who was diagnosed earlier this week with bird flu after returning from a trip to China has also tested positive for the virus, health officials said Friday.

What exactly is coronavirus?

Jan 30, 2015

The conflicts in Syria and Iraq are straining public health systems and public health efforts meant to prevent and detect the spread of infectious diseases. This is generating a "perfect storm" of conditions for outbreaks. Among the infections raising concern is Middle East Respiratory Syndrome, caused by a type of coronavirus, which emerged in 2012. ...

Scientists find Ebola virus is mutating

Jan 30, 2015

(Medical Xpress)—Researchers working at Institut Pasteur in France have found that the Ebola virus is mutating "a lot" causing concern in the African countries where the virus has killed over eight thous ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.