People with chronic kidney disease may have the same level of risk for coronary heart disease as people who have previously had a heart attack, a new study suggests.
It has long been known that chronic kidney disease patients are at increased risk for heart attacks, but this is the first study to show that their risk for heart disease may be as high as heart attack survivors.
For the study, researchers compared the incidence of heart attacks and death among 1.3 million people in Canada with chronic kidney disease, diabetes, previous heart attack or a combination of these risk factors.
The risk of heart attack among people with chronic kidney disease, diabetes or both was comparable to that of people who previously had a heart attack, found lead researcher Dr Marcello Tonelli, of the University of Alberta, and colleagues.
The findings, published in the journal The Lancet, suggest that kidney disease could be used to help identify people at risk for coronary heart disease.
How the study was done
"Our research suggests that there is a strong case for considering chronic kidney disease to be a coronary heart disease risk equivalent, meaning people with chronic kidney disease are at a comparable risk of coronary events to those who have previously had a heart attack," Tonelli said.
"Chronic kidney disease patients have substantially higher rates of death from heart disease after a heart attack than the general population, which emphasises the potential value of preventing coronary events through drug treatment and lifestyle interventions," Tonelli said. "The rate of death from heart disease among people with chronic kidney disease was similar to or higher than the rate of death among people with diabetes -- in whom the value of preventive treatments is well known."
The study findings need to be interpreted with caution, George Bakris, of the University of Chicago, noted in an accompanying editorial. Although the study was large, there was no information about patients' medication use or other factors such as blood pressure.
Because of this, the results do not "support classification of chronic kidney disease as a coronary heart disease risk equivalent," Bakris wrote in the editorial.
The National Kidney Foundation has more about chronic kidney disease.
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