Association of single measurement of estimated glomerular filtration rate and non-quantitative dipstick proteinuria with all-cause and cardiovascular mortality in the elderly. Results from the Progetto Veneto Anziani (Pro.V.A.) Study

作者：Zambon Sabina^*; Maggi Stefania; Zanoni Silvia; Romanato Giovanna; Noale Marianna; Corti Maria Chiara; Sartori Leonardo; Musacchio Estella; Baggio Giovannella; Sergi Giuseppe; Crepaldi Gaetano; Manzato Enzo

来源：Atherosclerosis, 2012, 220(1): 201-207.

DOI：10.1016/j.atherosclerosis.2011.09.023

• Estimated glomerular filtration rate
• Proteinuria
• All-cause mortality
• Cardiovascular mortality
• Elderly

Objective: To explore the independent and combined clinical validity of estimated glomerular filtration rate (eGFR) and proteinuria on predicting all-cause and cardiovascular mortality in an Italian elderly population. %26lt;br%26gt;Methods: Baseline eGFR and proteinuria, all-cause and cardiovascular mortality during a mean follow-up time of 4.4 years were evaluated in 3063 subjects aged 65 years and older of the Progetto Veneto Anziani (Pro. V. A.) Study. %26lt;br%26gt;Results: Subjects with eGFR %26lt; 60 ml/min/1.73m(2) (n = 956) presented a higher prevalence of proteinuria in comparison with those with eGFR %26gt;= 60 ml/min/1.73m(2) (33.8% vs 25.1%, p %26lt; 0.01). After multivariable adjustment including proteinuria and major diseases, eGFR %26lt; 60 ml/min/1.73m(2) was not associated with increased all-cause mortality. After multivariable adjustment including eGFR and major diseases, proteinuria was associated with all-cause mortality in overall subjects (HR = 1.43, 95% CI 1.15-1.78, p %26lt; 0.01), and in both sexes. After multivariable adjustment both eGFR %26lt; 60 ml/min/1.73m(2) (HR = 1.68, 95% CI 1.02-2.78, p = 0.04), and proteinuria (HR = 2.07, 95% CI 1.31-3.27, p %26lt; 0.01) were associated with increased cardiovascular mortality. Subjects with both impaired eGFR and presence of proteinuria showed a higher risk for both all-cause and cardiovascular mortality compared to those with normal eGFR and absence of proteinuria. %26lt;br%26gt;Conclusion: In this general Italian elderly population proteinuria is an independent predictor of all-cause and cardiovascular mortality, while eGFR is not an independent predictor of all-cause mortality, and it is nominally significantly associated with cardiovascular mortality. However, mortality risk is higher in individuals with combined reduced eGFR and proteinuria.

• 出版日期2012-1