ikely to die of cardiovascular problems, and 30 percent more likely to die of non-cardiovascular problems. They had increased risks of 40 percent for heart failure, 30 percent for heart attack, and 20 percent for stroke. Finally, they were more than three times more likely to develop chronic kidney disease.
"In contrast," the researchers report, "creatinine concentrations had associations with each outcome that were much weaker, and significant only for the outcome of cardiovascular death."
Shlipak says, "This tells us that the creatinine test, while broadly useful as a measure of kidney health, is insensitive. If a creatinine level is high, that's probably an indication of kidney disease. But if it's low, you don't know. You would need to do a cystatin test if there's any other indication of kidney disease or if the patient is in a group that's at risk."
Groups at risk for chronic kidney disease include people over 65, people with diabetes, hypertension, or cardiovascular disease, and African Americans, American Indians, and Hispanic Americans.
"This is also telling us that kidney function declines much more with age than we realized before," adds Shlipak. He terms this syndrome "pre-clinical kidney disease," or pre-CKD.
"We have the tools to slow kidney disease," he notes, including blood pressure control, sugar control for diabetes, and specific medications known as ACE inhibitors. "It's well-established that end-stage kidney disease is rising at a rate of 10 to 20 percent per year. With a heightened awareness of pre-CKD, we can be more aggressive in taking steps to prevent it."
Accurate knowledge of kidney function is also a matter of patient safety, according to Shlipak: "Surgery, some other medical procedures, and certain medications all can have an adverse impact on kidney health."
The cystatin test itself is relatively inexpensive and already widely available, he says. "As demanPage: 1 2 3 Related medicine news :1
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