Impaired Kidney Function Linked to Mortality in Elderly
Statins benefit high-risk patients with impaired function
25 jan 2009-- Impaired kidney function is associated with a higher risk of death and cardiovascular disease in elderly individuals at risk of vascular disease, while statins reduce the risk of death and heart attack in patients with impaired kidney function, according to the results of a study published online Jan. 20 in PLoS Medicine.
Ian Ford, Ph.D., from the University of Glasgow in Scotland, and colleagues determined whether estimated glomerular filtration rate (eGFR) could be used to predict cardiovascular disease and mortality using data from 5,804 older individuals (aged 70 to 82 years) at risk of vascular disease who had received pravastatin or placebo as part of a randomized clinical trial.
After adjusting for cardiovascular risk factors, the researchers found that a low eGFR (less than 40 compared with 60 mL/min/1.73 m 2 or more) was associated with a higher risk of all-cause mortality (hazard ratio, 2.04), vascular mortality (HR, 2.37), other non-cancer mortality (HR, 3.52), coronary heart disease death or non-fatal myocardial infarction (HR, 1.64), and fatal or non-fatal heart failure (HR, 3.31). Statin treatment was associated with reduced coronary heart disease death or non-fatal myocardial infarction in patients with low eGFR, the authors report.
"Impaired GFR is independently associated with significant levels of increased risk of all-cause mortality and fatal vascular events and with composite fatal and non-fatal coronary and heart failure outcomes," Ford and colleagues conclude. "Our analyses of the benefits of statin treatment in relation to baseline GFR suggest that there is no reason to exclude elderly patients with impaired renal function from treatment with a statin."