Chronic Renal Insufficiency, Cardiovascular Disease and Mortality in Women: A Causal Relationship or Coincidence?

Evaluation of: Kurth T, de Jong PE, Cook NR, Buring J: Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study. BMJ 338, B2769 (2009). The incidence of cardiovascular disease events and cardiovascular death in a cohort of 27,939 apparently healthy female health professionals over 45 years of age (Women's Health Study) who were stratified by estimated glomerular filtration rate (GFR) and followed for 12 years was assessed. Women with a GFR less than 60 ml/min/1.73m 2 demonstrated an increased risk of death from cardiovascular disease (HR: 1.68; 95% CI: 1.02–2.79) compared with women with a GFR higher than 90 ml/min/1.73 m 2 . There was no difference in risk when groups with decreased GFR of different ranges were compared with the group of women with normal GFR for first cardiovascular disease, all-cause mortality, myocardial infarction, stroke, coronary revascularization and noncardiovascular death.