Journal Article

Prevalence of renal impairment and its association with cardiovascular risk factors in a general population: results of the Swiss SAPALDIA study

Dorothea Nitsch, Denise Felber Dietrich, Arnold von Eckardstein, Jean-Michel Gaspoz, Sara H. Downs, Philippe Leuenberger, Jean-Marie Tschopp, Otto Brändli, Roland Keller, Margaret W. Gerbase, Nicole M. Probst-Hensch, Elisabeth Zemp Stutz and Ursula Ackermann-Liebrich

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 21, issue 4, pages 935-944
Published in print April 2006 | ISSN: 0931-0509
Published online January 2006 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfk021
Prevalence of renal impairment and its association with cardiovascular risk factors in a general population: results of the Swiss SAPALDIA study

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Background. Impaired renal function is evolving as an independent marker of the risk of cardiovascular morbidity and mortality. Little is known about the prevalence of impaired renal function and its relationship to cardiovascular risk factors in the Swiss general population.

Methods. SAPALDIA comprises a random sample of the Swiss population established in 1991, originally to investigate the health effects of long-term exposure to air pollution. Participants were reassessed in 2002/3 and blood measurements were obtained (n = 6317). Renal function was estimated using the Cockcroft–Gault equation and the modified MDRD (four-component) equation incorporating age, race, gender and serum creatinine level.

Results. The estimated prevalence of impaired renal function [estimated glomerular filtration rate <60 ml/min/1.73 m2] differed substantially between men and women, particularly at higher ages, and amounted to 13% [95% confidence interval (CI) 10–16%] and 36% (95% CI 32–40%) in men and women, respectively, of 65 years or older. Smoking, obesity, blood lipid levels, high systolic blood pressure and hyperuricaemia were all more common in men when compared with women. These cardiovascular risk factors were also associated independently with creatinine in both women and men. Women were less likely to receive cardiovascular drugs, in particular angiotensin-converting enzyme inhibitors and β-blockers, when compared with men of the same age.

Conclusion. Moderate renal impairment seems to be prevalent in the general population, with an apparent excess in females which is not explained by conventional cardiovascular risk factors. The unexpected finding questions the validity of the prediction equations, in particular in females.

Keywords: cardiovascular risk; cross-sectional survey; diabetes; general population; prevalence; renal impairment

Journal Article.  5923 words.  Illustrated.

Subjects: Nephrology

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