Association of risk factors for cardiovascular disease and glomerular filtration rate: a community-based study of 4,925 adults in Beijing

Abstract

Background: Several large prospective studies have reported that a low estimated glomerular filtration rate (eGFR) or chronic kidney disease (CKD) is independently associated with cardiovascular disease (CVD) events and all-cause mortality in high-risk populations. However, findings from community-based population studies are scarce and inconsistent. We investigated the level of eGFR and the relationship between CVD risk factors and eGFR or CKD in the population of Beijing, China.

Methods: This is a community-based observational survey in residents from three communities in Beijing for a routine health status checkup. Out of 5100 individuals who were eligible for inclusion, 4925 (96.57%) had complete data and were investigated the level of eGFR and the associated factors of reduced renal function. 2085 individuals with albuminuria values were included in the analyses on the associated factors of CKD. A questionnaire was used for risk factors of CVD. Anthropometry and blood pressure were measured. Serum creatinine, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and serum glucose were detected. The urine albumin-creatinine ratio (ACR) was used as an expression for albumin excretion. The oral glucose tolerance test was performed for the participants with no history of diabetes to diagnose diabetes. eGFR was evaluated by the Chinese modified Modification of Diet in Renal Disease equation. Reduced renal function was defined as normal renal function: eGFR ≥90 mL/min/1.73 m(2); mild reduced renal function: eGFR 89-60 mL/min/1.73 m(2); moderate to severe reduced renal function: eGFR <60 mL/min/1.73 m(2). CKD was diagnosed as eGFR <60 mL/min/1.73 m(2) or albuminuria was present.

Results: The prevalence of mild reduced renal function (eGFR 89-60 mL/min/1.73 m(2)), moderate to severe reduced renal function (eGFR <60 mL/min/1.73 m(2)) and CKD was 41.12% (2025/4925), 1.89% (93/4925) and 18.90% (394/2085) in the present study, respectively. The proportion of risk factors was higher in the low level of eGFR. Risk factors that exposed to reduced renal function were slightly different between male and female. The results of multivariate logistic regression analysis showed older age [increased by 10 years; odds ratios (OR) = 1.22], male gender (OR = 1.38), diabetes (OR = 1.67), hypertension (OR = 1.84) and hypertriglyceridaemia (≥1.7 mmol/L; OR = 1.68) were independently associated with CKD.

Conclusions: In the general population in Beijing, China, multiple CVD risk factors increased with a decline in eGFR and older age, hypertension, diabetes and elevated TG were independently associated with CKD.