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Renal Impairment Linked to Mortality in Women

Mild to moderate renal impairment is associated with increased risk of death from all causes in women and increased risk of coronary artery disease in men and women. Dr. Harry Hemingway from Royal Free and University College Medical School, London, UK stated that, “Often risk factor associations with obstructive coronary disease and mortality are similar or weaker in women, compared to men. “Renal function may be an example where this is not the case.”

Dr. Hemingway and colleagues investigated whether there were gender differences in the association of renal impairment with the presence of angiographically demonstrated coronary artery disease and with long-term outcomes, including all-cause, cardiovascular, and coronary deaths.

“As far as (we) are aware, ours is the first study to investigate gender differences in the influence of mild to moderate renal impairment on angiographic coronary artery disease and long-term mortality,” the investigators write.

Decreasing glomerular filtration rate (GFR) was associated with an increasing prevalence of coronary artery disease in women, but not in men, the authors report.

All-cause mortality, cardiovascular death, and coronary death were strongly related to decreasing GFR and both men and women, the results indicate.

For each of these outcomes, the researchers note, hazard ratios for women were consistently higher than those for men.

“Even mild to moderate renal impairment increased long-term mortality in both men and women with coronary artery disease,” Dr. Hemingway said. “While serum creatinine is already included as part of the routine work-up by cardiologists, acting on the results is less than routine. Cardiologists might consider lower thresholds for involving their nephrology colleagues in the care of their patients.”
J Am Coll Cardiol 2006;47:1182-1187