Kidney function as a predictor of noncardiovascular mortality

Linda F. Fried, Ronit Katz, Mark J. Sarnak, Michael G. Shlipak, Paulo H M Chaves, Nancy Swords Jenny, Catherine Stehman-Breen, Dan Gillen, Anthony J. Bleyer, Calvin H Hirsch, David Siscovick, Anne B. Newman

Research output: Contribution to journalArticle

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Abstract

Chronic kidney disease is associated with a higher risk for cardiovascular mortality, as well as all-cause mortality. Whether chronic kidney disease is a predictor of noncardiovascular mortality is less clear. To further explore the latter, the association of kidney function with total noncardiovascular mortality and cause-specific mortality was assessed in the Cardiovascular Health Study, a community-based cohort of older individuals. Kidney disease was assessed using cystatin C and estimated GFR in 4637 participants in 1992 to 1993. Participants were followed until June 30, 2001. Deaths were adjudicated as cardiovascular or noncardiovascular disease by committee, and an underlying cause of death was assigned. The associations of kidney function with total noncardiovascular mortality and cause-specific mortality were analyzed by proportional hazards regression. Noncardiovascular mortality rates increased with higher cystatin C quartiles (16.8, 17.1, 21.6, and 50.0 per 1000 person-years). The association of cystatin C with noncardiovascular mortality persisted after adjustment for demographic factors; the presence of diabetes, C-reactive protein, hemoglobin, and prevalent cardiovascular disease; and measures of atherosclerosis (hazard ratio 1.69; 95% confidence interval 1.33 to 2.15, for the fourth quartile versus the first quartile). Results for estimated GFR were similar. The risk for noncardiac deaths attributed to pulmonary disease, infection, cancer, and other causes was similarly associated with cystatin C levels. Kidney function predicts noncardiovascular mortality from multiple causes in the elderly. Further research is needed to understand the mechanisms and evaluate interventions to reduce the high mortality rate in chronic kidney disease.

Original languageEnglish (US)
Pages (from-to)3728-3735
Number of pages8
JournalJournal of the American Society of Nephrology
Volume16
Issue number12
DOIs
StatePublished - 2005

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Kidney
Mortality
Cystatin C
Chronic Renal Insufficiency
Kidney Diseases
C-Reactive Protein
Lung Diseases
Cause of Death
Atherosclerosis
Hemoglobins
Cardiovascular Diseases
Demography
Confidence Intervals
Health
Infection
Research
Neoplasms

ASJC Scopus subject areas

  • Nephrology

Cite this

Fried, L. F., Katz, R., Sarnak, M. J., Shlipak, M. G., Chaves, P. H. M., Jenny, N. S., ... Newman, A. B. (2005). Kidney function as a predictor of noncardiovascular mortality. Journal of the American Society of Nephrology, 16(12), 3728-3735. https://doi.org/10.1681/ASN.2005040384

Kidney function as a predictor of noncardiovascular mortality. / Fried, Linda F.; Katz, Ronit; Sarnak, Mark J.; Shlipak, Michael G.; Chaves, Paulo H M; Jenny, Nancy Swords; Stehman-Breen, Catherine; Gillen, Dan; Bleyer, Anthony J.; Hirsch, Calvin H; Siscovick, David; Newman, Anne B.

In: Journal of the American Society of Nephrology, Vol. 16, No. 12, 2005, p. 3728-3735.

Research output: Contribution to journalArticle

Fried, LF, Katz, R, Sarnak, MJ, Shlipak, MG, Chaves, PHM, Jenny, NS, Stehman-Breen, C, Gillen, D, Bleyer, AJ, Hirsch, CH, Siscovick, D & Newman, AB 2005, 'Kidney function as a predictor of noncardiovascular mortality', Journal of the American Society of Nephrology, vol. 16, no. 12, pp. 3728-3735. https://doi.org/10.1681/ASN.2005040384
Fried LF, Katz R, Sarnak MJ, Shlipak MG, Chaves PHM, Jenny NS et al. Kidney function as a predictor of noncardiovascular mortality. Journal of the American Society of Nephrology. 2005;16(12):3728-3735. https://doi.org/10.1681/ASN.2005040384
Fried, Linda F. ; Katz, Ronit ; Sarnak, Mark J. ; Shlipak, Michael G. ; Chaves, Paulo H M ; Jenny, Nancy Swords ; Stehman-Breen, Catherine ; Gillen, Dan ; Bleyer, Anthony J. ; Hirsch, Calvin H ; Siscovick, David ; Newman, Anne B. / Kidney function as a predictor of noncardiovascular mortality. In: Journal of the American Society of Nephrology. 2005 ; Vol. 16, No. 12. pp. 3728-3735.
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