Program / Abstract Book - KMU WWW3 Server for Education ...

No. 16 (PC 16)
Temporal changes in estimated glomerular filtration rate (delta eGFR) may be a
predictor of progression to coronary heart disease
So-Young Kim, Tae-Dong Jeong, Woochang Lee, Sail Chun, Won-Ki Min*
Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine,
Seoul, Korea
Background: Chronic kidney disease and cardiovascular disease are major public health problems
worldwide and often share the same pathophysiological mechanisms. Indeed, the prevalence of
traditional cardiovascular risk factors can be higher in those with impaired kidney function, and most
patients with a lower estimated glomerular filtration rate (eGFR) die of cardiovascular causes and not
due to progression to end stage renal disease. However, the effect of reduced eGFR on coronary heart
disease has not been well delineated among Korean population. Here, we reviewed temporal changes in
eGFR (delta eGFR, ΔeGFR) of the healthy Korean population, and then, carried out a study to
investigate the link between a ΔeGFR and the risk of coronary heart disease.
Methods: We reviewed data of 7676 healthy outpatients selected from a population of - 10,000
individuals referred to the health promotion center of the ASAN medical center between January 2010
and December 2010. At the time of the first evaluation, data of patients` age, sex, blood pressure,
creatinine, total cholesterol, LDL, HDL and triglycerides as well as history of smoking, hypertension or
familial coronary heart disease were collected by chart review. The % risk of coronary heart disease
were calculated by Framingham score (Score:www.nhlbi.nih.gov/guidelines/cholesterol). We classified
ΔeGFR % into 4 groups according to Gaussian distribution, ±2 standard deviation (SD); below -2SD,
-2SD to mean, mean to +2SD, over +2SD (mean=1.559, SD=9.5837).
Results: Among the enrolled patients, 5.9% (456 patients) were over 15 of the Framingham score, and
this is equivalent of coronary heart disease risk over 20% which means they have high risk for
occurrence of coronary heart disease in ten yrs. A group of over +2SD (ΔeGFR > 19.17%) had odds
ratio of 3.656, and it was related to incident % risk of coronary heart disease rather than other ΔeGFR
groups.
Conclusions: A decline of eGFR > 19.17% was independently related to incident % risk of coronary
heart disease. ΔeGFR could be a possible indicator of progression to the coronary heart disease in
general population. Therefore, this parameter may be potentially used for screening subjects with higher
risk of coronary heart disease.
Keywords: estimated glomerular filtration rate (eGFR), delta eGFR (ΔeGFR), coronary heart disease,
chronic kidney disease
- 69 -