Impact of history of cardiovascular disease on the development of chronic kidney disease

The relationship between chronic kidney disease (CKD) and risk of cardiovascular disease (CVD) has been proven many times, as has the relationship between diabetes, hypertension and development of CKD. The reverse relationship, CVD causing CKD, has been postulated, but has not been studied extensively. This study examined the relationship between history of CVD and CKD, defined by decreased glomerular filtration rate, and the impact of diabetes status. The study was limited to adults age 20 years and older from National Health and Nutrition Examination Survey (NHANES) 2005 – 2010 (n = 17,132). Multiple logistic regression was used to determine the independent relationships between the presence of CKD and the predictor variables (history of CVD, age, sex, race, BMI, hypertension, and diabetes). We found that history of CVD (OR 1.906, 95% CI 1.575 – 2.307), age (OR 1.099 [per year], 95% CI 1.09 – 1.109), females (OR 1.546, 95% CI 1.33 – 1.796), obesity (OR 1.428, 95% CI 1.196 – 1.706), and diabetes (OR 1.229, 95% CI 1.029 – 1.468) as the most significantly associated factors for CKD. Although this study is limited by the cross-sectional nature of NHANES, it does help improve the current knowledge behind the hypothesis that CVD is a risk factor for CKD. Longitudinal studies in cardiac patients should be undertaken to determine the presence or absence of CKD and the association of known risk factors for CVD in the presence of CKD and CVD.