eGFR, difference between eGFR and eGFR and heart failure: Insight from the NHANES 2001-2002 and Mendelian randomization analysis.

AIM

Estimated glomerular filtration rate (eGFR) derived from Cystatin C (eGFR), and the difference between Cystatin C and creatinine based eGFR (eGFR) has been suggested to be associated with cardiovascular disease. However, the association between eGFR,eGFR and heart failure (HF) risk has not been elucidated in a relatively healthy cohort.

METHODS

We used cohort study data from the NHANES 2001-2002. Mendelian randomization (MR) study used GWAS data from 437,846 European participants. The exposures are eGFR & eGFR, outcome is self reported heart failure. Weighted multivariable-adjusted logistic regression and Kaplan-Meier survival analysis was used in corhort study. Inverse variance weighted (IVW) was applied in MR study.

RESULTS

The cohort study included 2155 participants. Importantly, we simplified eGFR classification into ≥0 and < 0, and found that eGFR≥0 was associated with 52 % reduction of HF risk (OR 0.48, [95 % CI, 0.29-0.80], p = 0.005). We also found that 1 ml/min/1.73 m of eGFR had a significant negative association with HF after adjusting for covariates. Interestingly, we showed a non-linear association between eGFR and HF, eGFR and HF. In participants without know HF, during a median follow-up of 17.3 years, those in the low eGFR or low eGFR groups showed significantly poorer survival. Moreover, MR analysis found genetic predisposition to cystatin C was significantly associated with an increased risk of HF.

CONCLUSION

Both decreased eGFR and eGFR levels were associated with heart failure and poor survival, but the latter seems more obvious.