Level of Kidney Function Determines Cardiovascular Fate After Coronary Bypass Graft Surgery

Abstract

The traditional risk factors for cardiovascular (CV) disease, ie, hypertension, diabetes, or metabolic syndrome, are also risk factors for chronic kidney disease development.1 For more than a quarter of a century, the association between late-stage kidney disease, ie, glomerular filtration rate (GFR) <30 mL/min, and higher CV death rate has been recognized.2 Only recently, however, have studies in the general population3–5 and in cohorts with previous CV events6 linked the continuum of increasing CV risk with decreasing kidney function. This is related in part to the fact that current studies used validated formulas derived from kidney disease outcome trials7,8 to find an estimated GFR (eGFR) rather than simply measuring serum creatinine randomly. Articles pp 1056 and 1063 All studies published within the last decade indicate that when GFR falls to <60 mL/min (stage 3 nephropathy), a significant increase in CV events occurs.5,6 This may relate to the fact that as GFR falls to <60 mL/min, many physiological and regulatory functions of the kidney start to wane; such functions include reductions in 1,25[OH] vitamin D and erythropoietin synthesis. …