Abstract
Cardiovascular disease (CVD) is especially prevalent in patients with chronic kidney disease (CKD). To evaluate the role of CKD and metabolic syndrome (MS), which is a cluster of risk factors for CVD, as predictors of CVD. Observational, cross-sectional study with a random sample aged 45 or more years extracted from the population assisted by the primary care program in Niterói city in the state of Rio de Janeiro, Brazil. CKD was diagnosed by the K/DOQI guidelines and MS, by the harmonized criteria. CVD was said to be present if the participant had one or more of the following findings: echocardiographic abnormalities, and history of myocardial infarction, stroke or heart failure. A logistic regression model was developed to analyze risk factors for CVD using CKD as the variable of primary interest. Fifty hundred and eighty-one participants (38.2% male) with a mean age of 59.4 ± 10.2 years were analyzed. The prevalence rate of CKD was 27.9%. In participants without CKD, MS was associated with a slight but statistically significant increase in the risk for CVD (OR = 1.52, p = 0.037); in those with CKD but without MS the risk for CVD was also statistically significant and at a greater magnitude (OR = 2.42, p = 0.003); when both were present the risk for CVD was substantially higher (OR = 5.13, p < 0.001). In this study involving a population assisted by a primary care program, CKD was confirmed as an independent risk factor for CVD. The presence of MS concurrent with CKD substantially amplified the risk for CVD.
Highlights
Cardiovascular disease (CVD) is especially prevalent in patients with chronic kidney disease (CKD)
which is a cluster of risk factors for CVD
more years extracted from the population assisted by the primary care program
Summary
As variáveis contínuas foram expressas como média ± DP em caso de distribuição normal ou, caso contrário, como mediana e intervalo. Um modelo de regressão logística foi desenvolvido para analisar os fatores de risco para doenças cardiovasculares usando a DRC como variável de interesse primário. A frequência de DCV em cada grupo foi: CKD-/SM- 36,6%; DRC-/ SM+ 46,8%; DRC+/SM- 58,3% e DRC+/MS+ 74,7% - Tabela 2. A frequência foi estatisticamente maior em cada grupo quando comparados ao grupo DRC-/SM. Histórias de infarto do miocárdio e de acidente vascular cerebral foram estatisticamente maiores apenas no grupo DRC+/MS+ em comparação com o grupo DRC-/ SM-. A disfunção diastólica foi estatisticamente mais frequente em grupos com DRC. Desenvolvemos um modelo de regressão logística para analisar a associação de DRC com doenças cardiovasculares, ajustando-se para idade, cor da Frequência e porcentagem dos componentes da variável composta dos participantes nos quatro grupos
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