Abstract

Background: Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in adult-aged individuals. Associations with cardiovascular disease and mortality in such people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 106 participants randomized in the Prospective Study of Chronic  Kidney  Disease and  Risk of  Coronary  Artery  Disease. Aim of the study is to determine the predictive value of the GFR for mortality and morbidity using data from the (106) patients randomized in the Prospective Study. Patient and Methods: Glomerular filtration rate was estimated (eGFR) using the Modification of Diet in Renal Disease equation and was categorized in the ranges <60 mL • min−1 per 1.73 m2  and ≥ 60 ml/min/1.73 m2. Baseline risk factors were analyzed by category of eGFR, with and without adjustment for other risk factors. The associations between reduced eGFR and morbidity and mortality outcomes, accrued after the studied patients in the emergency department, were investigated using Cox proportional hazard models adjusting for traditional risk factors. We analyzed the declining eGFR and mortality risks in a patient with chronic kidney disease and have had coronary artery disease, including risk factors  (P=0.000)  for risk of coronary artery disease and ( p=0.0024) for mortality risks. Low eGFR was independently associated with risk of all-cause mortality, vascular mortality, and other noncancer mortality and with fatal and nonfatal coronary and heart failure events. Results: study included (106) men (54) and women (52) between the ages of 16 and 87 years, mean age (54.9±15.2). The eGFR data are calculated for all randomized study patients with eGFR <60ml/min/1.73 m287 (82%) and a group of patients with eGFR ≥60ml/min/1.73 m2 19 (18%). Patients were divided into the following three categories by estimated GFR (eGFR) at baseline: ≥90 (n = 4), 60 to 90 (n = 7), and <60 (n = 95) ml/min/1.73 m2. The outcome and death rates of this study among patients. Were analyzed. Overall (106) patients there was (44) death  42% mortality risk, patient with depress e GFR is 68 (78%) had positive history of (CAD) and 19 (22%) had negative history of (CAD), while in patients with eGFR ≥60 ml/min/1.73 m2 19 (18%), positive history of (CAD) is3 (15.8%) and negative history of (CAD) is16 (84.2%, P=0.000). group with depressed eGFR <60 ml/min/1.73 m2 and positive history of (CAD) 42 (48.2%), and with negative history is 45 (51.8%). In the eGFR ≥60 ml/min/1.73 m2 group and positive history of (CAD), the mortality rate is 2 (10.5%), and in the negative history (CAD) group is 17 (89.5%).The p=0.0024, χ2= 9.1.GFR Conclusion: This study established that impaired GFR in an adult population is independently associated with significant levels of increased risk of all-cause mortality and of fatal and nonfatal coronary and heart failure events; e-gfr change over time adds prognostic information to traditional mortality risk predictors among patients with CKD. The utility of incorporating e-GFR trends into patient-risk assessment should be further investigated