Clinical Feature and Outcome of Angiographic Coronary Artery Disease in Chronic Kidney Disease Patients
The prevalence and mortality rate of cardiovascular disease (CVD) in chronic kidney disease (CKD) patients is high. The prevalence of coronary artery disease (CAD) in CKD population ranges from 38 to 65%, with an average of 3.3 coronary lesions per person. The relative risk for death from myocardial infarction and CAD is 1.18 in CKD patients with GFR < 60 ml/min. Because of this high prevalence of CAD and its high mortality, reducing and preventing CAD risk factors is crucial in the clinical management of CKD patients.
Low glomerular filtration rate (GFR) constitutes an important independent risk factor for CAD. Several pathogenic factors play role in the genesis of cardiovascular dysfunction in chronic kidney disease. Increased traditional CAD risk factor, endothelial dysfunction, sympathetic hyperactivity, renin-angiotensin system activation, increased glycosylated end products, all contribute to the characteristic medial calcification of cardiovascular disease in CKD patients. Hypertension, fluid overloading and anemia further aggravated the cardiac loading, leading to myocardial hypertrophy with chamber dilatation, heart failure and death.
The mortality rate of CAD in CKD patients is extremely high. The NHANES II (National Health and Nutritional Evaluation Survey) found an increased of mortality rate> 51%, when the GFR decreased from > 90 to < 70 ml/min. The 1-year mortality rate in different CKD stage were 0.7% (normal renal function patients), 2.0% (patients with proteinuria), 3.5% (overt proteinuric patients) and 12.1% (dialysis patients), respectively. However, the clinical feature and outcome of CAD in different stage of CKD remains unclear.
We conducted a retrospective cohort study involving all patients admitted for coronary angiography from 1992 to 2004. The patients were categorized into five stages of CAD to compare the risk factor, clinical feature and outcome. Determination of this relationship can help to establish factors for early detection of CAD in CKD patients and also prognostic factor to improve outcome of these patients.
Coronary Artery Disease
Chronic Kidney Disease
|Study Design:||Observational Model: Cohort
Time Perspective: Retrospective
|Official Title:||Clinical Feature and Outcome of Angiographic Coronary Artery Disease in Chronic Kidney Disease Patients|
- all cause death [ Time Frame: 10 years ] [ Designated as safety issue: No ]
|Study Start Date:||April 2009|
|Estimated Study Completion Date:||December 2013|
CKD stage 1 patients
CKD stage 2 patients
CKD stage 3a patients
CKD stage 3b patients
CKD stage 4 patients
CKD stage 5 patients
Please refer to this study by its ClinicalTrials.gov identifier: NCT00651521
|Contact: I Wen Wu, MD||+886-2-24313131 ext email@example.com|
|Department of Nephrology,Chang Gung Memorial Hospital||Recruiting|
|Keelung, Taiwan, 240|
|Contact: I Wen Wu, MD +886-2-24313131 ext 3169 firstname.lastname@example.org|
|Principal Investigator: Iwen Wu, MD|
|Principal Investigator:||Iwen Wu, MD||Chang Gung Memorial Hospital|