During a seven year follow-up study, researchers found that people with mild chronic kidney disease (CKD) face double the risk of death from all causes after angioplasty or bypass surgery, and triple the risk of death from cardiovascular disease, compared to those without CKD. Our data suggests that mild CKD should raise a red flag for doctors to monitor patients more closely for heart disease, says lead author Lynda Anne Szczech, M.D., M.S.C.E., an assistant professor of medicine at Duke University Medical Center in Durham, N.C.

This is the first randomized trial to examine the effects of CKD on the outcomes of angioplasty and coronary artery bypass surgery, says Szczech. We found that even a small decrease in kidney function increases the risk for post-procedure complications, recurrent hospitalizations and repeat angioplasty within seven years of the initial procedure. One manifestation of kidney disease is end-stage renal disease (ESRD), which affects more than 300,000 people in the United States and requires blood-cleansing treatment on a dialysis machine. Many people with ESRD die of cardiovascular causes.

We know the risk of cardiovascular disease begins well before ESRD, during the period of CKD, she says. Mild CKD can have few symptomssometimes showing up only as blood tests for kidney function that fall out of the usual range. The condition is expected to become more common due to increasing rates of diabetes in this country and an aging population. The 3,608 patients in the study were part of a larger trial called the Bypass Angioplasty Revascularization Investigation (BARI), which randomly assigned patients to angioplasty or bypass surgery. In angioplasty,
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
22-Apr-2002