Glomerular filtration rate is related to severity of obstructive coronary artery disease in patients undergoing coronary angiography

• Published in: International urology and nephrology Vol. 44; no. 4; pp. 1161 - 1168
• Main Authors: Davoodi, Gholamreza, Mehrabi Pari, Samira, Rezvanfard, Mehrnaz, Sheikh Fathollahi, Mahmood, Amini, Manouchehr, Hakki, Elham, Kazemisaeid, Ali, Yaminisharif, Ahmad
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2012; Springer Nature B.V
• Subjects: Aged; Coronary Angiography; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - etiology; Coronary Stenosis - physiopathology; Female; Follow-Up Studies; Glomerular Filtration Rate - physiology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Nephrology - Original Paper; Prognosis; Renal Insufficiency - complications; Renal Insufficiency - physiopathology; Retrospective Studies; Risk Factors; Severity of Illness Index; Urology; Coronary angiography; Glomerular filtration rate (GFR); Renal insufficiency; Coronary artery disease (CAD)
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-011-0070-3

Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascular events; however, the relationship between the glomerular filtration rate (GFR) and coronary artery disease (CAD) in patients undergoing coronary angiography has yet to be fully elucidated. Methods This retrospective study enrolled a total of 7968 patients who underwent diagnostic coronary artery catheterization [mean age = 54.8 ± 10.6 years, 74.4% males] and did not have any previous history of coronary revascularization, diabetes mellitus, hypertension, end-stage renal disease treated by dialysis or renal transplantation, and were not taking diuretics or drugs acting on renin angiotensin system. The severity of CAD was defined as the number of coronary arteries with a luminal stenosis ≥50% on the angiogram, and the GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Results There were 2133 (26.8%) patients with GFR ≥ 90 ml/min/1.73 m 2 , 4574 (57.4%) patients with 60 ≤ GFR < 90 ml/min/1.73 m 2 , 1073 (13.5%) with 45 ≤ GFR < 60 ml/min/1.73 m 2 and 181 (2.3%) with 15 < GFR < 45 ml/min/1.73 m 2 . After adjustment for traditional cardiovascular risk factors (age, sex, dyslipidemia, low to high-density lipoprotein ratio, smoking status, and family history), the GFR showed a significant association with the severity of CAD and remained a significant predictor of CAD (Odds Ratio raised from 1.1 in patients with 60 ≤ GFR < 90 ml/min/1.73 m 2 to 1.8 in patients with 15 < GFR < 45 ml/min/1.73 m 2 ). Conclusions A reduced kidney function, even mildly, is significantly associated with CAD severity, independently of other traditional CAD risk factors.