Cell Biochemistry and Biophysics

, Volume 69, Issue 1, pp 55–59 | Cite as

Correlation of Chronic Renal Dysfunction and Albuminuria with Severity of Coronary Artery Lesions in Patients with Coronary Artery Disease

Original Paper


This study was conducted to investigate the possible correlation of chronic renal dysfunction and albuminuria with the severity of coronary artery lesions in patients with coronary artery disease (CAD). Two-hundred and ninety-nine patients who had undergone coronary angiography for suspected CAD were stratified into three groups according to the glomerular filtration rate (GFR): group I included 144 patients with normal renal function GFR >90 ml/(min × 1.73 m2), group II included 97 patients with mild renal impairment GFR 60–89 ml/(min × 1.73 m2), and group III included 58 patients with moderate renal impairment GFR <60 ml/(min × 1.73 m2). Patients were then stratified into two groups according to the albuminuria level (0; minimal, 1+, 2+, 3+): the albuminuria negative group (negative = 0) included 171 patients and the albuminuria positive group (positive = minimal, 1+, 2+, 3+) included 128 patients. Clinical features and coronary lesion characteristics were compared among these groups. Patients with more severe renal dysfunction and positive albuminuria had a higher incidence of CAD (66.7 vs. 70.1 vs. 72.4 %, p = 0.025 and 64.2 vs. 75.0 %, p = 0.032), more multi-vessel disease (31.2 vs. 41.2 vs. 53.4 %, p = 0.004 and 33.3 vs. 46.1 %, p = 0.015), more left anterior descending branch lesions (50.7 vs. 56.7 vs. 60.3 %, p = 0.012 and 49.1 vs. 61.7 %, p = 0.009), and a higher Gensini score (42.3 ± 14.7 vs. 46.1 ± 19.9 vs. 52.8 ± 21.2, p = 0.026 and 44.0 ± 16.0 vs. 50.5 ± 20.2, p = 0.017). In conclusion, chronic renal dysfunction and albuminuria may be important factors determining the occurrence and the severity of CAD. Albuminuria was an especially significant indicator at the early stage of renal dysfunction.


Renal dysfunction Glomerular filtration rate Albuminuria Coronary artery disease Coronary artery lesion Gensini score 


  1. 1.
    Foley, R. N., Parfrey, P. S., & Sarnak, M. J. (1998). Clinical epidemiology of cardiovascular disease in chronic renal disease. American Journal of Kidney Diseases, 32, S112–S119.PubMedCrossRefGoogle Scholar
  2. 2.
    McCullough, P. A. (2002). Cardiorenal risk: An important clinical intersection. Reviews in Cardiovascular Medicine, 3, 71–76.PubMedCrossRefGoogle Scholar
  3. 3.
    Yuyun, M. F., Khaw, K. T., Luben, R., Welch, A., Bingham, S., Day, N. E., et al. (2004). A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population: the EPIC-Norfolk study. American Journal of Epidemiology, 159, 284–293.PubMedCrossRefGoogle Scholar
  4. 4.
    Perkovic, V., Verdon, C., Ninomiya, T., Barzi, F., Cass, A., Patel, A., et al. (2008). The relationship between proteinuria and coronary risk: A systematic review and meta-analysis. PLoS Medicine, 5, 1486–1495.CrossRefGoogle Scholar
  5. 5.
    Gensini, G. G. (1983). A more meaningful scoring system for determining the severity of coronary heart disease. American Journal of Cardiology, 51, 606. doi:10.1016/S0002-9149(83)80105-2.PubMedCrossRefGoogle Scholar
  6. 6.
    Sarnak, M. J., Levey, A. S., Schoolwerth, A. C., Coresh, J., Culleton, B., Hamm, L. L., et al. (2003). Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation, 108, 2154–2169.PubMedCrossRefGoogle Scholar
  7. 7.
    Elsayed, E. F., Tighiouart, H., Griffith, J., Kurth, T., Levey, A. S., Salem, D., et al. (2007). Cardiovascular disease and subsequent kidney disease. Archives of Internal Medicine, 167, 1130–1136.PubMedCrossRefGoogle Scholar
  8. 8.
    Fox, C. S., Larson, M. G., Leip, E. P., Culleton, B., Wilson, P. W., & Levy, D. (2004). Predictors of new-onset kidney disease in a community-based population. JAMA, 291, 844–850.PubMedCrossRefGoogle Scholar
  9. 9.
    Weiner, D. E., Tighiouart, H., Stark, P. C., Amin, M. G., MacLeod, B., Griffith, J. L., et al. (2004). Kidney disease as a risk factor for recurrent cardiovascular disease and mortality. American Journal of Kidney Diseases, 44, 198–206.PubMedCrossRefGoogle Scholar
  10. 10.
    Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., & Hsu, C. Y. (2004). Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New England Journal of Medicine, 351, 1296–1305.PubMedCrossRefGoogle Scholar
  11. 11.
    Weiner, D. E., Tighiouart, H., Amin, M. G., Stark, P. C., MacLeod, B., Griffith, J. L., et al. (2004). Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: A pooled analysis of community-based studies. Journal of the American Society of Nephrology, 15, 1307–1315.PubMedCrossRefGoogle Scholar
  12. 12.
    Shlipak, M. G., Sarnak, M. J., Katz, R., Fried, L. F., Seliger, S. L., Newman, A. B., et al. (2005). Cystatin C and the risk of death and cardiovascular events among elderly persons. New England Journal of Medicine, 352, 2049–2060.PubMedCrossRefGoogle Scholar
  13. 13.
    Fried, L. F., Shlipak, M. G., Crump, C., Bleyer, A. J., Gottdiener, J. S., Kronmal, R. A., et al. (2003). Renal insufficiency as a predictor of cardiovascular outcomes and mortality in elderly individuals. Journal of the American College of Cardiology, 41, 1364–1372.PubMedCrossRefGoogle Scholar
  14. 14.
    Shlipak, M. G., Fried, L. F., Cushman, M., Manolio, T. A., Peterson, D., Stehman-Breen, C., et al. (2005). Cardiovascular mortality risk in chronic kidney disease: Comparison of traditional and novel risk factors. JAMA, 293, 1737–1745.PubMedCrossRefGoogle Scholar
  15. 15.
    Di Angelantonio, E., Chowdhury, R., Sarwar, N., Aspelund, T., Danesh, J., & Gudnason, V. (2010). Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: Prospective population based cohort study. BMJ, 341, c4986. doi:10.1136/bmj.c4986.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Nakano, T., Ninomiya, T., Sumiyoshi, S., Fujii, H., Doi, Y., Hirakata, H., et al. (2010). Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: The Hisayama study. American Journal of Kidney Diseases, 55, 21–30.PubMedCrossRefGoogle Scholar
  17. 17.
    Li, B., Qi, H., Yu, D., Shang, Y. J., Chu, D. F., Mao, L. M., et al. (2009). Prevalence of chronic kidney disease and its related factors in Chinese elderly persons. Chinese Journal of Geriatrics, 28, 250–253 (in Chinese).Google Scholar
  18. 18.
    Agrawal, V., Marinescu, V., Agarwal, M., & McCullough, P. A. (2009). Cardiovascular implications of proteinuria: An indicator of chronic kidney disease. Nature Reviews Cardiology, 6, 301–311.PubMedCrossRefGoogle Scholar
  19. 19.
    Berton, G., Cordiano, R., Mazzuco, S., Katz, E., De, T. R., & Palatini, P. (2008). Albumin excretion in acute myocardial infarction: A guide for long-term prognosis. American Heart Journal, 156, 760–768.PubMedCrossRefGoogle Scholar
  20. 20.
    Jackson, C. E., Solomon, S. D., Gerstein, H. C., Zetterstrand, S., Olofsson, B., Michelson, E. L., et al. (2009). Albuminuria in chronic heart failure: Prevalence and prognostic importance. Lancet, 374, 543–550.PubMedCrossRefGoogle Scholar
  21. 21.
    Shlipak, M. G., Ix, J. H., Bibbins-Domingo, K., Lin, F., & Whooley, M. A. (2008). Biomarkers to predict recurrent cardiovascular disease: The Heart and Soul Study. American Journal of Medicine, 121, 50–57.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Klausen, K., Borch-Johnsen, K., Feldt-Rasmussen, B., Jensen, G., Clausen, P., Scharling, H., et al. (2004). Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes. Circulation, 110, 32–35.PubMedCrossRefGoogle Scholar
  23. 23.
    Mosca, L., Banka, C. L., Benjamin, E. J., Berra, K., Bushnell, C., Dolor, R. J., et al. (2007). Evidence-based guidelines for cardiovascular disease prevention in women: 2007 Update. Circulation, 115, 1481–1501.PubMedCrossRefGoogle Scholar
  24. 24.
    Rein, P., Vonbank, A., Saely, C. H., Beer, S., Jankovic, V., Boehnel, C., et al. (2011). Relation of albuminuria to angiographically determined coronary arterial narrowing in patients with and without type 2 diabetes mellitus and stable or suspected coronary artery disease. American Journal of Cardiology, 107, 1144–1148.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of CardiologyThe First Affiliated Hospital of China Medical UniversityShenyangChina

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