 |
|
Renal Function and Heart Failure Risk in Older Black and White Individuals
The Health, Aging, and Body Composition Study
Kirsten Bibbins-Domingo, PhD, MD;
Glenn M. Chertow, MD, MPH;
Linda F. Fried, MD, MPH;
Michelle C. Odden, BS;
Anne B. Newman, MD, MPH;
Stephen B. Kritchevsky, PhD;
Tamara B. Harris, MD, MS;
Suzanne Satterfield, MD;
Steven R. Cummings, MD;
Michael G. Shlipak, MD, MPH
Arch Intern Med. 2006;166:1396-1402.
Background Chronic kidney disease is a risk factor for heart failure, an association that may be particularly important in blacks who are disproportionately affected by both processes. Our objective was to determine whether the association of chronic kidney disease with incident heart failure differs between blacks and whites.
Methods The study population comprised participants in the Health, Aging, and Body Composition Study without a diagnosis of heart failure (1124 black and 1676 white community-dwelling older persons). The main predictors were quintiles of cystatin C and creatinine concentrations and estimated glomerular filtration rate. The main outcome measure was incident heart failure.
Results Over a mean 5.7 years, 200 participants developed heart failure. High concentrations of cystatin C and low estimated glomerular filtration rate were each associated with heart failure, but the magnitude was greater for blacks than for whites (cystatin C concentration: adjusted hazard ratio for quintile 5 [ 1.18 mg/dL] vs quintile 1 [<0.84 mg/dL] was 3.0 [95% confidence interval 1.4-6.5] in blacks and 1.4 [95% confidence interval, 0.8-2.5] in whites; estimated glomerular filtration rate: adjusted hazard ratio for quintile 5 (<59.2 mL/min) vs quintile 1 (>86.7 mL/min) was 2.7 [95% confidence interval, 1.4-4.9] in blacks and 1.8 [95% confidence interval, 0.9-3.6] in whites). For cystatin C, this association was observed at more modest decrements in kidney function among blacks as well. The population attributable risk of heart failure was 47% for blacks with moderate or high concentrations of cystatin C (0.94 mg/dL) (56% prevalence) but only 5% among whites (64% prevalence).
Conclusion The association of kidney dysfunction with heart failure appears stronger in blacks than for whites, particularly when cystatin C is used to measure kidney function.
Author Affiliations: Division of General Internal Medicine, San Francisco General Hospital, San Francisco, Calif (Dr Bibbins-Domingo); Department of Medicine and Department of Epidemiology and Biostatistics, University of California, San Francisco (Drs Bibbins-Domingo, Chertow, Cummings and Shlipak); The Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, Pa (Dr Fried); The Renal-Electrolyte Division (Dr Fried) and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health and the Division of Geriatric Medicine (Dr Newman), University of Pittsburgh School of Medicine, Pittsburgh; General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco (Ms Odden and Dr Shlipak); Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Kritchevsky); Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Md (Dr Harris); Department of Preventive Medicine, University of Tennessee, Memphis (Dr Satterfield); and California Pacific Medical Center Research Institute, San Francisco (Dr Cummings).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Epidemiology of Incident Heart Failure in a Contemporary Elderly Cohort: The Health, Aging, and Body Composition Study
Kalogeropoulos et al.
Arch Intern Med 2009;169:708-715.
ABSTRACT
| FULL TEXT
Racial Differences in Incident Heart Failure among Young Adults
Bibbins-Domingo et al.
NEJM 2009;360:1179-1190.
ABSTRACT
| FULL TEXT
The Differential Association of Kidney Dysfunction With Small and Large Arterial Elasticity: The Multiethnic Study of Atherosclerosis
Peralta et al.
Am J Epidemiol 2009;169:740-748.
ABSTRACT
| FULL TEXT
Association of chronic kidney disease with outcomes in chronic heart failure: a propensity-matched study
Campbell et al.
Nephrol Dial Transplant 2009;24:186-193.
ABSTRACT
| FULL TEXT
Subclinical Thyroid Dysfunction, Cardiac Function, and the Risk of Heart Failure: The Cardiovascular Health Study
Rodondi et al.
J Am Coll Cardiol 2008;52:1152-1159.
ABSTRACT
| FULL TEXT
Racial Differences in Mortality Among Those with CKD
Mehrotra et al.
J. Am. Soc. Nephrol. 2008;19:1403-1410.
FULL TEXT
Elevated Cystatin C Concentration and Progression to Pre-Diabetes: The Western New York Study
Donahue et al.
Diabetes Care 2007;30:1724-1729.
ABSTRACT
| FULL TEXT
Reduced Kidney Function as a Risk Factor for Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study
Kottgen et al.
J. Am. Soc. Nephrol. 2007;18:1307-1315.
ABSTRACT
| FULL TEXT
|
