Background: Chronic kidney disease (CKD) has been identified as a risk factor for cardiovascular disease (CVD).
Methods and results: The risk of cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. Participants (mean age, 52.4 years) free of previous CVD were followed up for 10 years. Glomerular filtration rate (GFR) was estimated using the abbreviated equation developed at the Cleveland Clinic laboratory for the Modification of Diet in Renal Disease study. Of the 7,316 participants, 6.7% had CKD with a GFR<60 at baseline. Even after adjustment for other risk factors, the presence of CKD conferred an increased risk of cardiovascular death with a hazard ratio of 1.20 (95% confidence interval, 0.82-1.76). Furthermore, a negative, graded correlation between GFR and risk of cardiovascular death was observed: 1.09 (0.72-1.64) for a 60<or=GFR<90, 1.15 (0.67-1.99) for a 45<or=GFR<60, 1.23 (0.49-3.09) for a 30<or=GFR<45, 5.52 (1.62-18.75) for a 15<or=GFR<30, 9.12 (2.12-39.29) for a GFR<15, as compared with normal kidney function (GFR>or=90). The proportion of excess cardiovascular death due to CKD was 1.3%.
Conclusion: CKD was an independent risk factor for cardiovascular death in a community-dwelling Japanese population.