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Multicenter Study
. 2018 Jun;71(6):450-457.
doi: 10.1016/j.rec.2017.09.010. Epub 2017 Oct 28.

Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe

[Article in English, Spanish]
Betlem Salvador-González  1 , Neus Gil-Terrón  2 , M Jesús Cerain-Herrero  3 , Isaac Subirana  4 , Roser Güell-Miró  5 , Luisa M Rodríguez-Latre  6 , Oriol Cunillera-Puértolas  7 , Roberto Elosua  8 , Maria Grau  9 , Joan Vila  4 , Luisa Pascual-Benito  10 , Jordi Mestre-Ferrer  11 , Rafel Ramos  12 , José Miguel Baena-Díez  13 , Maria Soler-Vila  14 , Eva Alonso-Bes  14 , Laura Ruipérez-Guijarro  10 , Virtudes Álvarez-Funes  5 , Esther Freixes-Villaró  2 , Mercedes Rodríguez-Pascual  10 , Alberto Martínez-Castelao  15
Affiliations
Multicenter Study

Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe

[Article in English, Spanish]
Betlem Salvador-González et al. Rev Esp Cardiol (Engl Ed). 2018 Jun.

Abstract

Introduction and objectives: Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59mL/min/1.73 m2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence.

Methods: We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively.

Results: The median was age 70 years, and 56.1% were women; 13.5% had eGFR < 60 (69.7% eGFR 45-59). During a median follow-up of 38.2 months, 6474 participants died and 3746 had a CVE. For ACM and CVE, the HR in older individuals became significant at eGFR < 60. Fully adjusted HR for ACM in the eGFR 45 to 59 category were 1.61; 95%CI, 1.37-1.89 and 1.19; 95%CI, 1.10-1.28 in 60- to 74-year-olds and ≥ 75-year-olds, respectively; for CVE HR were 1.28; 95%CI, 1.08-1.51 and 1.12; 95%CI, 0.99-1.26.

Conclusions: In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk.

Keywords: All-cause mortality; Cardiovascular disease; Elderly; Enfermedad cardiovascular; Estimated glomerular filtration rate; Factor de riesgo; Individuos mayores; Mortalidad total; Risk factors; Tasa de filtrado glomerular estimada.

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