Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 538356
Title Cardiovascular Risk Factors Accelerate Kidney Function Decline in Post−Myocardial Infarction Patients : The Alpha Omega Cohort Study
Author(s) Esmeijer, Kevin; Geleijnse, Johanna M.; Fijter, Johan W. de; Giltay, Erik J.; Kromhout, Daan; Hoogeveen, Ellen K.
Source Kidney International Reports 3 (2018)4. - ISSN 2468-0249 - p. 879 - 888.
DOI https://doi.org/10.1016/j.ekir.2018.03.005
Department(s) Chair Nutrition and Disease
VLAG
Human Nutrition (HNE)
Publication type Refereed Article in a scientific journal
Publication year 2018
Keyword(s) cardiovascular risk factors - kidney function decline - lifestyle
Abstract

Introduction: Impaired kidney function is a robust risk factor for cardiovascular mortality. Age-related annual kidney function decline of 1.0 ml/min per 1.73 m2 after age 40 years is doubled in post−myocardial infarction (MI) patients. Methods: We investigated the impact of the number of cardiovascular risk factors (including unhealthy lifestyle) on annual kidney function decline, in 2426 post-MI patients (60−80 years) of the prospective Alpha Omega Cohort study. Glomerular filtration rate was estimated by serum cystatin C (eGFRcysC) and combined creatinine−cystatin C (eGFRcr-cysC), using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations from 2012. Data were analyzed by multivariable linear and logistic regression. Results: At baseline, mean (SD) eGFRcysC and eGFRcr-cysC were 81.5 (19.6) and 78.5 (18.7) ml/min per 1.73 m2, respectively. Of all patients, 79% were men, 19% had diabetes, 56% had high blood pressure (≥140/90 mm Hg), 16% were current smokers, 56% had high serum low-density lipoprotein (LDL of ≥2.5 mmol/l), and 23% were obese (body mass index of ≥30.0 kg/m2). After multivariable adjustment, the additional annual eGFRcysC decline (95% confidence interval) was as follows: in patients with versus without diabetes, −0.90 (−1.23 to −0.57) ml/min per 1.73 m2; in patients with high versus normal blood pressure, −0.50 (−0.76 to −0.24) ml/min per 1.73 m2; in obese versus nonobese patients, −0.31 (−0.61 to 0.01) ml/min per 1.73 m2; and in current smokers versus nonsmokers, −0.19 (−0.54 to 0.16) ml/min per 1.73 m2. High LDL was not associated with accelerated eGFRcysC decline. Similar results were obtained with eGFRcr-cysC. Conclusion: In older, stable post-MI patients without cardiovascular risk factors, the annual kidney function decline was −0.90 (−1.16 to −0.65) ml/min per 1.73 m2. In contrast, in post-MI patients with ≥3 cardiovascular risk factors, the annual kidney function decline was 2.5-fold faster, at −2.37 (−2.85 to −1.89) ml/min per 1.73 m2.

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