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Silent Kidney Disease Tied To Heart Attacks And Early Death

Posted: Friday, August 15, 2008

Chronic kidney disease doubles the risk of heart attack, stroke, and early mortality, even among young and middle-aged adults, according to results of a nationwide screening program. 
Chronic kidney disease is a recognized risk factor for cardiovascular disease in elderly people. New data from the National Kidney Foundation's Kidney Early Evaluation Program (KEEP), reported in the August issue of the American Heart Journal, provides the first proof that the danger is not restricted to people over the age of 65.

The research team at William Beaumont Hospital in Royal Oak, Michigan, was led by Dr. Peter A. McCullough, vice chair of the Foundation's KEEP program.

"We used to think that chronic kidney disease was just an issue of getting older," Dr. McCullough said. "But when we took age out of the equation, we found that kidney disease can affect even young adults."

However, by routinely testing all adults for kidney disease, those at risk for premature cardiovascular disease can be identified and treated, increasing their chances of a normal lifespan.

In the study, more than 30,000 individuals over 18 years of age with a family history of hypertension, diabetes, or chronic kidney disease were tested between 2000 and 2005. Participants answered questions about past heart attacks and strokes, and blood and urine specimens were collected for laboratory testing.

To ensure that results could not be attributed to old age, the study was restricted to men less than 55 years old and women less than 65 years old. The researchers determined mortality by cross-checking against national data systems.

Twenty percent of subjects were found to have chronic kidney disease (CKD).

Among those with CKD, roughly 5% had a premature heart attack or stroke, versus 2.5% of those without CKD. The mortality rate was four times higher in the CKD group (total 50 deaths out of 6000 individuals during the 5 years after screening) than in those with normal kidney function (total 44 deaths out of 23,000 individuals).

The worst survival occurred among those with both CKD and a history of heart attack or stroke.

"The vast majority of these people were in the prime of their life," Dr. McCullough noted. "This is a call to action that Americans need to improve their health."

He suggests that kidney damage causes biological changes in the body that accelerate vascular injury throughout the body.

He recommends that all adults at risk for kidney disease -- anyone who is overweight, smokes or has high blood pressure, diabetes, and a family history of kidney disease-- routinely be checked for albumin in their urine and for reduced kidney function. If detected, risk factors for heart disease and stroke have to be addressed.

"These simple tests can motivate patients to change their lives including losing body fat, controlling blood pressure, treating diabetes, and quitting cigarette smoking," he said.

Source: Diabetes In Control

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