Analysis of data from the Framingham Heart Study suggests that risk factors for cardiovascular disease are also powerful predictors for development of kidney disease, according to an article in the February 18th issue of the Journal of the American Medical Association. The established cardiovascular risk factors that were considered in the study included hypertension, smoking, diabetes, and obesity.

According to background information provided by the authors, "hypertension and diabetes are the leading causes of end-stage renal disease (ESRD). Among individuals who develop ESRD, the risk of cardiovascular disease is 10 to 20 times higher than the general population, and increased risks are evident even in mild kidney disease." The authors state there are approximately 275,000 patients with end-stage renal disease in the U.S. and an estimated 8 million additional U.S. adults have kidney disease.

Caroline S. Fox, M.D., M.P.H., and her colleagues analyzed data from 1,223 men and 1,362 women in the Framingham Offspring Study who had a baseline examination in 1978 to 1982 and returned for a follow-up examination in 1998 to 2001. None of the participants had baseline kidney disease. After an average follow-up of 18.5 years, 244 participants (9.4 percent) had developed kidney disease. The researchers defined kidney disease as a decrease in glomerular filtration rate to the fifth percentile or lower, based on national definitions.

The researchers found that established cardiovascular disease risk factors predicted the development of kidney disease. "In addition, a mildly reduced glomerular filtration rate at baseline increased the odds of developing kidney disease. Our data indicate that among unselected participants, diabetes, hypertension, obesity, smoking, low HDL-C level, and a mild reduction in glomerular filtration rate are important risk factors for the development of new-onset kidney disease," the authors concluded. "Patients with mildly reduced glomerular filtration rate should be monitored for progression to kidney disease."