Tasa de filtrado glomerular estimada, eventos cardiovasculares y mortalidad por grupos de edad en individuos de 60 o más años del sur de Europa

espanolIntroduccion y objetivos Los individuos con tasa de filtrado glomerular estimada (TFGe) disminuida tienen mayor riesgo de muerte por todas las causas (MT) y cardiovascular; se debate si los sujetos mayores con TFGe entre 45 y 59 ml/min/1,73 m2 tambien tienen un riesgo aumentado. Se evaluo la asociacion entre la TFGe y la MT y los eventos cardiovasculares (ECV) en individuos de edad 60-74 y ≥ 75 anos en un area de baja incidencia de enfermedad coronaria. Metodos Se realizo un estudio retrospectivo de cohortes utilizando registros electronicos de atencion primaria y hospital. Se incluyo a 130.233 individuos de 60 o mas anos con una determinacion de creatinina entre el 1 de enero de 2010 y el 31 de diciembre de 2011 y una TFGe segun la formula de la Chronic Kidney Disease Epidemiology Collaboration. Las asociaciones independientes entre la TFGe y la MT y el ingreso por ECV se evaluaron mediante modelos de regresion de Cox y Fine-Gray respectivamente. Resultados Media de edad, 70 anos; el 56,1% eran mujeres. El 13,5% tenia una TFGe Conclusiones En un area de baja incidencia de enfermedad coronaria, el riesgo de muerte y ECV fue de mayor a menor TFGe. A edades ≥ 75 anos, la categoria de TFGe 45-59, en el limite significativo de ECV, incluyo a muchos individuos sin riesgo adicional significativo. EnglishIntroduction and objectives Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59 mL/min/1.73 m2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence. Methods We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively. Results The median was age 70 years, and 56.1% were women; 13.5% had eGFR Conclusions In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk