The Contribution of Early Nephropathy to Cardiovascular Risk

Patients with an estimated glomerular filtration rate (eGFR) of less than 60 mL/min per 1.72 m 2 , and presence of microalbuminuria (MA), have an increased risk of cardiovascular (CV) events, compared with patients with normal renal function. The strength of the association among patients with a mild reduction in eGFR depends largely on the population studied, whereas the data regarding MA show an elevated risk among both low- and high-risk populations. Patients with mildly reduced eGFR or MA experience a reduction in CV events and progression of renal disease with treatment of CV risk factors. For patients who experience a myocardial infarction, observational data suggest that patients with a mildly reduced eGFR also have improved outcomes with an early invasive strategy, compared with a noninvasive strategy. However, whether targeting therapy to normalize renal function also confers a reduction in CV events remains unknown.