Blog entry by Meguid El Nahas
An analysis by Clase and colleagues (Ann Intern Med. 2011;154:310-318) based on the ONTARGET cohort shows that adding albuminuria or eGFR to traditional CVD risk factors adds little to the CVD predictive value of the latter. This analysis is in agreement with that made by Chang and Kramer in Nephron that reviewed studies a number of studeis showing that traditional predictive scors for CVD improve little by adding parameters of renal function. Whilst there is little doubt that Albuminuria and eGFR predict CVD outcomes as well as CVD mortality and all cause mortality, doubt is emerging whether they have added predictive value when combined to traditional risk scores such as the Framingham Risk Score. Further analysis is needed to clarify this issue. After all, the majority of CKD in communities are older individuals over the age of 65. In those traditional CVD risk scores may suffice. On the other hand, albuminuria and/or eGFR may have a useful additional predictive value in lower risk and young individuals with little underlying CVD. Further analysis is needed to clarify that important issue.