News Release

Chronic kidney disease patients could be at similar levels of coronary risk to those who have previously had a heart attack

Peer-Reviewed Publication

The Lancet_DELETED

While it has long been established that patients with chronic kidney disease are at higher risk of heart attacks, the new study is the first large-scale, long-term study to examine whether kidney disease should be considered to be equivalent to having previously suffered a heart attack, in terms of the risk of future coronary events.

Lead researcher Dr Marcello Tonelli of the University of Alberta, said: "Our research suggests that there is a strong case for considering chronic kidney disease to be a coronary heart disease risk equivalent, meaning that people with chronic kidney disease are at a comparable risk of coronary events to those who have previously had a heart attack. Chronic kidney disease patients have substantially higher rates of death from heart disease after a heart attack than the general population, which emphasises the potential value of preventing coronary events through drug treatment and lifestyle interventions. In fact, the rate of death from heart disease among people with chronic kidney disease was similar to or higher than the rate of death among people with diabetes – in whom the value of preventive treatments is well known. "*

The study examined records from almost 1.3 million patients in Canada, comparing the incidence of heart attacks and death in patients with chronic kidney disease, diabetes, at least one previous heart attack, or a combination of these risk factors. The researchers found that people with chronic kidney disease, diabetes, or both, tended to experience a comparable risk of heart attack to those who had previously had a heart attack, suggesting that kidney disease could prove to be a useful prognostic marker for coronary heart disease.

The findings are important because patients identified as having a coronary heart disease risk equivalent can receive targeted treatment – for example, with drugs such as statins, which reduce the risk of coronary events due to their effects of lowering "bad" fats (lipids) in the bloodstream. In the UK, almost 9% of the population are thought to suffer from chronic kidney disease, which often – but not always – accompanies diabetes, already thought of as a coronary heart disease risk equivalent.

In an accompanying Comment, George Bakris of The University of Chicago, urges caution in the interpretation of the results, suggesting that although the study's large scale is an advantage, a lack of information about individuals' medication and other factors such as blood pressure means that the findings don't necessarily provide clear-cut support for the classification of chronic kidney disease as a coronary heart disease risk equivalent.

However, even if further analysis fails to support the classification of chronic kidney disease as a coronary heart disease risk equivalent, the work is still likely to have important implications for coronary disease prevention strategies. As Professor Bakris states: "Tonelli and colleagues offer new insight by comparing individuals with chronic kidney disease with those who have a history of heart attack, on a very large scale. Their findings emphasise the importance of primary prevention, particularly because patients with chronic kidney disease comprise a large proportion of patients who have heart attack."

###

Professor Marcello Tonelli, Department of Medicine, The University of Alberta, Canada T) +1 780 248 2048 (c/o Quinn Philips) or +1 780 407 8520 E) mtonelli@ualberta.ca

For Professor George Bakris, Department of Medicine, The University of Chicago Medicine, USA, please contact John Easton, Senior science writer, The University of Chicago Medicine, T) +1 773-795-5225 or +1 773-322-7380 (mobile) E) john.easton@uchospitals.edu

Notes to Editors

*Quote direct from authors and cannot be found in text of Article.


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.