Kidney health better indicator of heart disease risk

Simple parameters of the kidney's functions and damage may be better at predicting the risk of heart failure and death from heart attack and stroke than traditional tests of cholesterol levels and blood pressure, new research suggests.

The data may help physicians make better decisions on whether patients need lifestyle modifications such as better diets and more exercise or treatments such as statins, medication widely used for preventing cardiovascular diseases, the study said.

"Cholesterol levels and blood pressure tests are good indicators of cardiovascular risk, but they are not perfect. This study tells us we could do even better with information that often times we are already collecting," said study lead author Kunihiro Matsushita, assistant scientist at the Johns Hopkins Bloomberg School of Public Health.

"If healthcare providers have data on kidney damage and kidney function -- which they often do -- they should be using those data to better understand a patient's risk of cardiovascular disease," Matsushita said.

The most common assessment of kidney function checks the blood for creatinine, a waste product of the muscles, and reflects how well the kidneys are filtering it out (called an estimated glomerular filtration rate, or GFR).

Another key test measures albuminuria, or how much of the protein albumin leaks out of the kidney and into the urine.

The researchers analysed data from 24 studies that included more than 637,000 participants with no history of cardiovascular disease and the results of tests of GFR and albuminuria.

They found that both GFR levels and albuminuria independently improved prediction of cardiovascular disease in general, particularly heart failure and death from heart attack and stroke, but albuminuria was the stronger predictor.

It outperformed cholesterol levels and systolic blood pressure - and whether someone is a smoker - as a risk factor for heart failure and death from heart attack or stroke.

The study was published in the journal Lancet Diabetes and Endocrinology.