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(Stroke. 2008;39:2876.)
© 2008 American Heart Association, Inc.

Research Letters

The Association Between Kidney Disease and Cardiovascular Risk in a Multiethnic Cohort

Findings From the Northern Manhattan Study (NOMAS)

Thomas L. Nickolas, MD, MS; Minesh Khatri, MD; Bernadette Boden-Albala, DrPH; Krzysztof Kiryluk, MD; Xiaodong Luo, PhD; Palma Gervasi-Franklin, BA; Myunghee Paik, PhD Ralph L. Sacco, MD, MS

From Department of Medicine (T.L.N., K.K.), Department of Neurology (B.B.A., M.K., R.L.S., X.L., P.G.F.), Department of Sociomedical Science (B.B.A.), Department of Biostatistics (X.L., M.C.P.), College of Physicians and Surgeons, and the Mailman School of Public Health, Columbia University, New York, NY; and the Departments of Neurology and Epidemiology (R.L.S.), Miller School of Medicine, University of Miami, Fla.

Correspondence to Thomas L. Nickolas, MD, MS, Assistant Professor of Medicine, Columbia University Medical Center, Division of Nephrology, 622 West 168th Street, PH 4 Stem, Room 124, New York, NY 10032; E-mail tln2001{at}columbia.edu

Background and Purpose— The objective of this study was to determine the relationship between chronic kidney disease (CKD), race–ethnicity, and vascular outcomes.

Methods— A prospective, multiracial cohort of 3298 stroke-free subjects with 6.5 years of mean follow-up time for vascular outcomes (stroke, myocardial infarction, vascular death) was used. Kidney function was estimated using serum creatinine and Cockcroft-Gault formula. Cox proportional hazards models were fitted to evaluate the relationship between kidney function and vascular outcomes.

Results— In multivariate analysis, Cockcroft-Gault formula between 15 and 59 mL/min was associated with a significant 43% increased stroke risk in the overall cohort. Blacks with Cockcroft-Gault formula between 15 and 59 mL/min had significantly increased risk of both stroke (hazard ratio, 2.65; 95% CI, 1.47 to 4.77) and combined vascular outcomes (hazard ratio, 1.59; 95% CI, 1.10–2.92).

Conclusion— Chronic kidney disease is a significant risk factor for stroke and combined vascular events, especially in blacks.

Key Words: cardiac • chronic kidney disease • epidemiology • outcome • risk factors • stroke

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