A large, retrospective study indicates that young adults with kidney function below what is expected for their age, but not yet at the threshold for chronic kidney disease (CKD), have a greater risk for adverse cardiovascular outcomes in the coming years. The study focused on adults younger than 40 with an estimated glomerular filtration rate (eGFR) of 90 to 99 mL/min/1.73 m2 and found significantly higher risks of major adverse cardiovascular events (MACE) and MACE plus heart failure compared to better renal function. The increased risk was found to be even greater at lower levels of kidney function.
The relationship between slight declines in eGFR and cardiovascular events was surprising and concerning to the researchers. They argue that there is a need to change the current one-size-fits-all approach to diagnosing kidney disease. Currently, CKD is defined as an eGFR below 60 mL/min/1.73 m2 across all age groups. The researchers suggest that different levels of kidney disease or kidney impairment should be recognized based on age.
While it is unclear what actions should be taken in response to a subclinical decline in renal function, the researchers emphasize the importance of recognizing that it is a problem. They recommend the monitoring of young people with lower-than-expected renal function for disease progression and screening for other established cardiovascular risk factors. Implementing lifestyle changes such as exercising, adopting a healthy diet, and quitting smoking may also be beneficial for both heart and kidney health.
The findings of this study highlight the need to pay more attention to kidney function as a risk factor for cardiovascular disease, especially in young and middle-aged adults. The researchers suggest that routine measurement of eGFR and urine albumin excretion should be considered in addition to other tests used in routine medical screening. This information could guide preventive measures and treatments for CKD. Checking albuminuria and obtaining eGFR are easy and cost-effective tests that can provide valuable information about kidney function.
Source: Charytan, D.M., Craven, T., Oparil, S., et al. (2023). Effect of Intensive Blood Pressure Lowering on Kidney Tubular Injury, Inflammation, and Fibrosis in Healthy Participants Adjusted for Blood Pressure Reduction: A Randomized Clinical Trial. JAMA Intern Med. 下一个宜
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