Early CKD screening in CAD patients must include eGFR, UACR: study

A recent study has emphasized the importance of early screening for chronic kidney disease (CKD) among patients with coronary artery disease (CAD). Both estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio (UACR) must be included in the test to provide a complete diagnosis.

“Without UACR, half of those with CKD would remain undetected,” the investigators said.

The analysis included 4,548 CAD patients (age range: 18‒80 years; 79.6 percent males), who were assessed for eGFR and UACR 6 to 24 months after their CAD diagnosis. Of these, 3,865 had complete information on kidney function and cardio-renal protective therapy, while 3,577 (92.5 percent) had available follow-up data after a median of 1 year.

CKD was present in nearly one in three (32 percent) patients, of whom 19.7 percent were classified as low-moderate, 6.9 percent as high, and 5.6 percent as very high risk. In the absence of UACR, more than half of these patients (51.3 percent) would have been undetected.

The primary event (first of cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure) occurred in 7.9 percent of patients, with the highest incidence seen in the high-risk group (men: 13.0 percent; women: 11.8 percent). Such association was independent of other risk factors and evident following the index examination.

Notably, only a few patients received adequate cardio-renal protective therapy.

“Treatment with cardio-renal protective therapy was low, providing great potential for improvement,” the investigators said.