eGFR and albuminuria are associated with the risk of CV events in HIV+
{"Image DocumentName": "eGFR and albuminuria are associated with the risk of CV events in HIV+", "Image ImageDescription": "Veterans Affairs cohort : HIV+ Risque d accidents cardiovasculaires selon DFG ou albuminurie. Renal dysfunction increases the risk of cardiovascular disease. Although many patients with chronic kidney disease will progress to end-stage renal disease (ESRD), the risk of cardiovascular disease (CVD) is substantially higher than the risk of ESRD [1]. The excess CVD risk in people with chronic kidney disease is caused at least in part by a higher prevalence of traditional CVD risk factors in this group than in the general population, especially, older age, high blood pressure, high blood cholesterol and lipids, and diabetes [1]. Even after stratification for sex, race, and the presence of diabetes however, CVD mortality is 10\u201330 times higher in patients treated by dialysis than in patients in the general population. After stratification for age, CVD mortality remains five-fold higher in dialysis patients than in the general population [2]. The chart in the slide shows data from a large, community-based population of more than 1 million men and women [3]. Longitudinal GFR was estimated among 1,120,295 adults in whom serum creatinine had been measured and who had not undergone dialysis or kidney transplantation. The adjusted hazard ratio for cardiovascular events increased inversely with the estimated GFR: 1.4 for GFR 45\u201359 ml/min/1.73 m2 (95% confidence interval, 1.4\u20131.5) 2.0 for GFR 30\u2013-44 ml/min/1.73 m2 (95% confidence interval, 1.9\u20132.1) 2.8 for GFR 15\u201329 ml/min/1.73 m2 (95% confidence interval, 2.6\u20132.9) 3.4 for GFR <15 ml/min/1.73 m2 (95% confidence interval, 3.1\u20133.8). Similarly, the adjusted risk of death or hospitalisation increased was GFR decreased. In summary, an independent, graded association was observed between a reduced estimated GFR and the risk of death, cardiovascular events, and hospitalisation. References. Rosamond W, et al. Circulation 2007; 115:69\u2013171. Sarnak MJ, et al. Circulation 2003; 108:2154\u20132169. Go AS, et al. N Eng J Med 2004; 351:1296\u20131305. eGFR: Estimated Glomerular Filtration Rate. Choi A et al. Circulation. 2010;121:", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}