Abstract: Background: Coronary heart disease (CHD) is the primary cause of death in individuals with chronic kidney disease (CKD),
but current equations for assessing coronary risk have low accuracy in this group. We have reported that the addition of a
genetic risk score (GRS) to the Framingham risk function improved its predictive capacity in the general population. The
aims of this study were to evaluate the association between this GRS and coronary events in the CKD population and to
determine whether the addition of the GRS to coronary risk prediction functions improves the estimation of coronary risk
at the earliest possible stages of kidney disease.
Methods: A total of 632 CKD patients, aged 35?74 years, who had Stage 4?5 CKD, were on dialysis, had a functioning renal
transplant or had returned to dialysis after transplant failure were included and followed up for a mean of 9.3 years. The
transitions between disease states and the development of coronary events were registered. The increase in predictive ability
that was obtained by including the GRS was measured as the improvement in the C-statistic and as the net reclassification
Results: The GRS was independently associated with the risk of CHD (hazards ratio 1.34; 95% confidence interval 1.04?1.71;
P¼0.022), especially in Stages 4 and 5 CKD, and kidney transplant patients. A coronary risk prediction function that incorporated
chronic kidney disease (CKD) disease state, age, sex and the GRS had significantly greater predictive capacity (AUC
70.1, P¼0.01) and showed good reclassification (net reclassification improvement 28.6).
Conclusion: This new function, combining genetic and clinical data, identifies CKD patients with a high risk of coronary
events more accurately, allowing us to prevent such events more effectively.
Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria
Fuente: Clinical Kidney Journal, 2017, vol. 10, no. 5, 672-678
Editorial: Oxford University Press
Año de publicación: 2017
Nº de páginas: 7
Tipo de publicación: Artículo de Revista