RESUMEN
Objetivos: Determinar la prevalencia de insuficiencia renal en población mayor de 49 años de edad con enfermedad arterial periférica y analizar su relación con factores de riesgo y enfermedad cardiovascular. Material y métodos: Estudio epidemiológico prospectivo de 3 años de duración con selección por muestreo aleatorio simple en población general de edad superior a 49 años. Se recogieron datos demográficos, clínicos, prevalencia de factores de riesgo y enfermedad cardiovascular. Se definió enfermedad arterial periférica (EAP) por índice tobillo-brazo ≤ 0,9 e insuficiencia renal crónica (IRC) según valores de filtrado glomerular estimado por la fórmula MDRD < 60 ml/min/1,73 m2. Se presentan datos basales. Resultados: Se incluyeron 511 personas de 66,6 (9,7) años de edad media (desviación estándar), 37% varones. La prevalencia de EAP fue del 12,4% (n = 63) de la muestra, de 72,6 años de edad media, 46% varones. La presencia de enfermedad renal crónica en estadios 3-5 fue del 39,7%. Los pacientes con EAP e IRC, en comparación con los que tenían función renal normal, eran de mayor edad (75,6 vs. 70,6, p = 0,08), predominantemente mujeres (64 vs. 47,4%, p = no significativa [ns]), presentaban cifras más elevadas de presión arterial sistólica y diastólica (159,2 vs. 146,1, p = ns y 85,7 vs. 80,3 mmHg, p = 0,09), proteína C reactiva (1,23 vs. 0,38 mg/dl, p = 0,05) y cociente albúmina-creatinina (90,2 vs. 26,4 mg/g, p = ns). En este grupo, la prevalencia de factores de riesgo cardiovascular y enfermedad cardiovascular asociada fueron notablemente superiores, sin alcanzar significación estadística. Conclusiones: La insuficiencia renal está presente en el 39,7% de los pacientes con EAP y delimita un subgrupo de pacientes con elevado riesgo cardiovascular (AU)
Objectives: To determine the prevalence of kidney failure in people older than 49 years old with peripheral arterial disease and to analyse its relationship with risk factors and cardiovascular disease. Material and method: Prospective epidemiological study 3 years in duration with selection by simple random sampling in the general population aged over 49 years. Data on demographic, clinical, prevalence of risk factors and cardiovascular disease were registered. We defined peripheral arterial disease (PAD) by ankle-brachial index (ABI) <0.9 and chronic kidney disease (CKD) according to estimated glomerular filtration rates by the MDRD <60 ml/min/1.73m2. Baseline data are presented. Results: 511 people were included. The mean age was 66.6 (9.7) years (SD), 37% were men. The prevalence of PAD was 12.4% (N=63) of the sample, average age 72.6 years, 46% men. The presence of CKD stages 3-5 was 39.7%. Patients with PAD and CKD compared with those with normal renal function were older (75.6 vs. 70.6, p=0.08), predominantly women (64% vs 47.4%, p=ns), and showed higher values for systolic and diastolic blood pressure (159.2 vs 146.1, p=ns and 85.7 vs 80.3 mmHg, p=0.09), CRP (1.23 vs 0.38 mg/dl, p=0.05) and albumin creatinine ratio (90.2 vs 26.4 mg/g, p=ns). In this group, the prevalence of cardiovascular risk factors and associated cardiovascular disease, were significantly higher without reaching statistical significance. Conclusions: Kidney failure is present in 39.7% of patients with PAD and it defines a subgroup of patients with high cardiovascular risk (AU)
Asunto(s)
Humanos , Insuficiencia Renal Crónica/epidemiología , Enfermedad Arterial Periférica/epidemiología , Estudios Prospectivos , Tasa de Filtración Glomerular , Atención Primaria de Salud/estadística & datos numéricos , Factores de RiesgoRESUMEN
OBJECTIVES: To determine the prevalence of kidney failure in people older than 49 years old with peripheral arterial disease and to analyse its relationship with risk factors and cardiovascular disease. MATERIAL AND METHOD: Prospective epidemiological study 3 years in duration with selection by simple random sampling in the general population aged over 49 years. Data on demographic, clinical, prevalence of risk factors and cardiovascular disease were registered. We defined peripheral arterial disease (PAD) by ankle-brachial index (ABI) ≤0.9 and chronic kidney disease (CKD) according to estimated glomerular filtration rates by the MDRD <60 ml/min/1.73m2. Baseline data are presented. RESULTS: 511 people were included. The mean age was 66.6 (9.7) years (SD), 37% were men. The prevalence of PAD was 12.4% (N=63) of the sample, average age 72.6 years, 46% men. The presence of CKD stages 3-5 was 39.7%. Patients with PAD and CKD compared with those with normal renal function were older (75.6 vs. 70.6, p=0.08), predominantly women (64% vs 47.4%, p=ns), and showed higher values for systolic and diastolic blood pressure (159.2 vs 146.1, p=ns and 85.7 vs 80.3 mmHg, p=0.09), CRP (1.23 vs 0.38 mg/dl, p=0.05) and albumin creatinine ratio (90.2 vs 26.4 mg/g, p=ns). In this group, the prevalence of cardiovascular risk factors and associated cardiovascular disease, were significantly higher without reaching statistical significance. CONCLUSIONS: Kidney failure is present in 39.7% of patients with PAD and it defines a subgroup of patients with high cardiovascular risk.
Asunto(s)
Enfermedad Arterial Periférica/epidemiología , Insuficiencia Renal/epidemiología , Anciano , Anciano de 80 o más Años , Índice Tobillo Braquial , Proteína C-Reactiva/análisis , Enfermedades Cardiovasculares/epidemiología , Comorbilidad , Creatinina/sangre , Complicaciones de la Diabetes/epidemiología , Dislipidemias/epidemiología , Femenino , Tasa de Filtración Glomerular , Humanos , Fallo Renal Crónico/sangre , Fallo Renal Crónico/epidemiología , Masculino , Persona de Mediana Edad , Enfermedad Arterial Periférica/sangre , Prevalencia , Estudios Prospectivos , Insuficiencia Renal/sangre , Factores de Riesgo , Muestreo , España/epidemiologíaRESUMEN
Introducción y objetivos. Las determinaciones de cistatina C se han propuesto como nuevo marcador de la función renal y predictor del riesgo cardiovascular en ancianos. Nuestro objetivo fue conocer la prevalencia de individuos con cistatina C elevada en población general y su asociación con factores de riesgo y enfermedad cardiovascular. Métodos. Estudio epidemiológico descriptivo transversal por muestreo aleatorio simple en población general mayor de 49 años, obtenido de la base de tarjeta sanitaria individual. Fueron seleccionados 415 pacientes de los que se realizó la determinación de cistatina C a 359 de ellos utilizando un método inmunonefelométrico. Como punto de corte se aceptó el recomendado para el método en adultos. Resultados. Se estudió a 359 pacientes (media de edad ± desviación estándar, 64 ± 10 años; el 63,5%, mujeres); presentó cistatina C elevada el 17,3% (intervalo de confianza del 95%, 13,4%-21,2%), con concentraciones medias de 0,81 ± 0,21 mg/l, que aumentaban con la edad. Las elevaciones de cistatina C se asociaron con: mayor edad (p < 0,0001), presión arterial sistólica (p < 0,0001), hemoglobina A1c (p = 0,031), triglicéridos (p = 0,019), homocisteína (p < 0,0001), proteína C reactiva (p = 0,015), fibrinógeno (p = 0,006), microalbuminuria (p = 0,001) y menor cifra de colesterol de las lipoproteínas de alta densidad (p = 0,021) y filtrado glomerular estimado (p < 0,0001). Las enfermedades cardiovasculares concomitantes fueron la cardiopatía isquémica (p = 0,013) y la insuficiencia cardiaca (p = 0,038). Los principales factores asociados de manera independiente con elevaciones de cistatina C fueron la diabetes (odds ratio [OR] = 5,37), el sexo masculino (OR = 4,91) y el filtrado glomerular descendido (OR = 0,83). Conclusiones. Encontramos una alta prevalencia de individuos con cistatina C elevada en la población general, lo que conlleva factores de riesgo cardiovascular clásicos, como diabetes, hipertensión arterial y enfermedad renal crónica, junto con concentraciones más elevadas de proteína C reactiva, homocisteína y fibrinógeno (AU)
Introduction and objectives. Cystatin C has been proposed as a novel marker of renal function and as a predictor of cardiovascular risk in the elderly. The aim of this study was to determine the prevalence of an elevated cystatin C level in the general population and its relationship with cardiovascular risk factors and disease. Methods. This descriptive epidemiologic cross-sectional study involved a simple randomized sample of individuals aged >49 years from the general population, and was based on personal health records. From the final selection of 415 individuals, 359 underwent cystatin C measurement using a immunonephelometric assay. The cut-point used was that recommended for the method in adults. Results. Of the 359 individuals (mean±standard deviation age, 64±10 years, 63.5% female) studied, 17.3% (95% confidence interval [CI] 13.4%-21.2%) had an elevated cystatin C level. The mean level was 0.81±0.21 mg/L, and increased with age. Elevation of the cystatin C level was associated with: older age (P < .0001); high measures of systolic blood pressure (P < .0001), hemoglobin A1c (P=.031), triglycerides (P=.019), homocysteine (P < .0001), C-reactive protein (P=.015), fibrinogen (P=.006) and microalbuminuria (P=.001); and a low high-density lipoprotein cholesterol level (P=.021) and estimated glomerular filtration rate (P < .0001). Associated cardiovascular diseases included coronary heart disease (P=.013) and heart failure (P=.038). The main factors independently associated with an elevated cystatin C level were diabetes (odds ratio [OR]=5.37), male sex (OR=4.91) and decreased glomerular filtration (OR=0.83). Conclusions. The prevalence of an elevated cystatin C level in the general population was found to be high and was associated with the presence of classical cardiovascular risk factors such as diabetes, hypertension and chronic renal disease, along with higher levels of C-reactive protein, homocysteine and fibrinogen (AU)
Asunto(s)
Humanos , Cistatinas , Insuficiencia Renal Crónica/epidemiología , Enfermedades Cardiovasculares/epidemiología , Factores de Riesgo , Tasa de Filtración Glomerular , Proteína C-Reactiva , Fibrinógeno , Homocisteína , Hipertensión/epidemiologíaRESUMEN
INTRODUCTION AND OBJECTIVES: Cystatin C has been proposed as a novel marker of renal function and as a predictor of cardiovascular risk in the elderly. The aim of this study was to determine the prevalence of an elevated cystatin C level in the general population and its relationship with cardiovascular risk factors and disease. METHODS: This descriptive epidemiologic cross-sectional study involved a simple randomized sample of individuals aged >49 years from the general population, and was based on personal health records. From the final selection of 415 individuals, 359 underwent cystatin C measurement using a immunonephelometric assay. The cut-point used was that recommended for the method in adults. RESULTS: Of the 359 individuals (mean+/-standard deviation age, 64+/-10 years, 63.5% female) studied, 17.3% (95% confidence interval [CI] 13.4%-21.2%) had an elevated cystatin C level. The mean level was 0.81+/-0.21 mg/L, and increased with age. Elevation of the cystatin C level was associated with: older age (P< .0001); high measures of systolic blood pressure (P< .0001), hemoglobin A1c (P=.031), triglycerides (P=.019), homocysteine (P< .0001), C-reactive protein (P=.015), fibrinogen (P=.006) and microalbuminuria (P=.001); and a low high-density lipoprotein cholesterol level (P=.021) and estimated glomerular filtration rate (P< .0001). Associated cardiovascular diseases included coronary heart disease (P=.013) and heart failure (P=.038). The main factors independently associated with an elevated cystatin C level were diabetes (odds ratio [OR]=5.37), male sex (OR=4.91) and decreased glomerular filtration (OR=0.83). CONCLUSIONS: The prevalence of an elevated cystatin C level in the general population was found to be high and was associated with the presence of classical cardiovascular risk factors such as diabetes, hypertension and chronic renal disease, along with higher levels of C-reactive protein, homocysteine and fibrinogen.