Minimisation of risk factors for the development of vascular disease has made a major contribution to the decline in vascular morbidity and mortality reported over the last decade. Recent evidence has highlighted that elevation of serum creatinine is a strong marker of increased vascular risk, with a predictive value as high as the development of diabetes. As serum creatinine is easily measured — albeit often misinterpreted — this provides another easily applied clinical tool for the stratification of cardiovascular risk and the targeting of preventative medicine in primary and secondary care.
Parfrey JS, Foley RNThe clinical epidemiology of cardiac disease in chronic renal failure . J Am Soc Nephrol1999;10:1606-15.
2.
Goodman WG, Goldin J., Kuizon BD et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med2000;342:1478.
3.
Franklin SS, Khan SA, Wong ND et al. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham Heart Study. Circulation1999;100:354-60.
4.
Levin A., Thompson CR, Ethier J. et al. Left ventricular mass index increase in early renal disease: impact of decline in haemoglobin. Am J Kid Dis1999;34:125-34.
5.
Culleton BF, Larson MG, Wilson PW et al. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney Int1999;56:2214-19.
6.
Wannamethee SG, Shaper AG, Perry IJSerum creatinine concentration and risk of cardiovascular disease: a possible marker of increased risk of stroke. Stroke1997;28:557-63.
7.
Henry DMA , Kostense PJ, Bos G., Stehouwer CDA.Mild renal insufficiency is associated with increased cardiovascular mortality: the Hoorn Study. Kidney Int2002;62:1402-07.
8.
ARIC study. J Am Soc Nephrol2001;12:225A.
9.
Mann JF, Gerstein HC, Pogue J., Bosch J., Yusuf S.Renal insufficiency as a predictor of cardiovascular outcomes and the impact of ramipril: the HOPE randomized trial. Ann Intern Med2001;134:629-36.
10.
Haffner SM, Lehto S., Ronnemaa T., Pylorala K., Laakso M.Mortality from coronary heart disease in subjects with type 2 diabetes and in non-diabetic subjects with and without prior myocardial infarction . N Engl J Med1998;339:229-34.
11.
Ruilope LM, Salvetti A., Jamerson K. et al. Renal function and intensive lowering of blood pressure in hypertensive participants of the hypertension optimal treatment (HOT) study. J Am Soc Nephrol2001;12:218-25.
12.
Shulman NB, Ford CE, Hall WD et al. Prognostic value of serum creatinine and effect of treatment of hypertension on renal function. Results form the hypertension detection and follow-up programme. The Hypertension Detection and Follow-up Program Cooperative Group. Hypertension1989;13(suppl 5):180-93.
13.
Flack JM, Neaton JD, Daniels B. et al. Ethnicity and renal disease: Lessons from the MRFIT trial and the treatment of mild hypertension study. Am J Kidn Dis1993;21(suppl 1):31-40.
14.
Dinneen SF, Gerstein HCThe association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. A systematic overview of the literature. Arch Intern Med1997;157:1413-18.
15.
Viberti G., Chaturvedi N.Angiotensin converting enzyme inhibitors in diabetic patients with microalbuminuria or normoalbuminuria. Kidney Int1997;63:S32-S35.
