Coronary heart disease associated with markers of kidney dysfunction


Coronary heart disease associated with markers of kidney dysfunction

Biomarkers for certain types of kidney dysfunction, such as proteinurea or albinurea, could be associated with coronary heart disease (CHD), according to an article released on October 20, 2008 in the open-access journal PLoS Medicine.

In CHD, atherosclerotic plaques build up around the walls of arteries and vessels in the body. This blocks flow of blood to organs that may need it -- and if this occurs in blood flow to the heart, the result can be CHD, sometimes in the form of a heart attack. Several risk factors have previously been identified for this disorder, including smoking, high blood cholesterol levels, diabetes, or overweight status. However, kidney disease is a potential risk factor that has not been adequately addressed in previous research.

Proteinurea, in which the patient has increased levels of protein in the urine, or albinurea, in which the specific protein increased is albumin, both indicate debilitation in the kidney's ability to filter properly. Previous studies have been inconclusive about these conditions' associations with CHD.

To investigate these potential associations, Vlado Perkovic and colleagues from the George Institute for International Health, Sydney, Australia performed a systematic review and meta-analysis of 26 previously published cohort studies. Combined, these analyses followed almost 170,000 subjects through more than 7,000 coronary disease events.

After adjustment for other risk factors identified for CHD, the authors found a strong and continuous association between both proteinurea and CHD risk. Notably, this risk possibly increased as the severity of the kidney dysfunction increased, indicating the potential for a dose-response relationship, which could have powerful implications on the clinical use of this indicator for CHD risk.

The authors suggest that proteinurea should be considered for future studies of CHD risk, though the impact of these potential interventions must be thoroughly researched before implementation. "The findings of this study therefore strongly support a role for the evaluation of proteinuria in the prediction of CHD risk," they say. However, they add: "Studies to assess the impact of these strategies are warranted."

The relationship between proteinuria and coronary risk: A systematic review and meta-analysis.

Perkovic V, Verdon C, Ninomiya T, Barzi F, Cass A, et al.

PLoS Med 5(10): e207.

doi:10.1371/journal.pmed.0050207

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Section Issues On Medicine: Cardiology