Estimated glomerular filtration rate as an independent predictor of atherosclerotic vascular disease in older women

Complete 10-year verified mortality and hospitalization discharge records for atherosclerotic vascular disease was collected for a prospective study of 1,239 unselected female subject’s？≥？70 from the Calcium Intake Fracture Outcome Study (CAIFOS) with 10？years of follow-up. eGFR was compared to the current Framingham risk scores.The eGFR at baseline using the Modification of Diet in Renal Disease Study (MDRD) equation was 65.2？±？14.5？mL/min/1.73？m2 and 66.3？±？13.5？mL/min/1.73？m2 using the Chronic Kidney Disease EPIdemiology (CKD-EPI) equation. Over 10？years 30% of participants sustained an ASVD hospitalization or death. For every standard deviation (SD) reduction in eGFR using MDRD the odds ratio (OR) for ASVD hospitalization and deaths increased by 1.34 (1.18-1.53), P？<？0.001and 1.31 (1.14-1.50), P？<？0.001 in a model adjusted for Framingham 10-year general cardiovascular risk. Addition of eGFR by the MDRD equation to Framingham risk factors improved the net reclassification index by 5.9%, P？=？0.018 and the integrated discrimination improvement by 0.010？±？0.003, P？<？0.001 Similar results were seen using the CKD-EPI equation.Estimated glomerular filtration rate predicts ASVD outcomes independently of Framingham risk score predictions in elderly women and improves clinical prediction particularly of early ASVD.