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Background Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC. Methods Using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR 2 and > 25% decline). Results Among the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77), was associated with greater odds of incident CKD. Conclusions LAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.

New data highlight the increasing global burden of cardiovascular disease, end-stage renal disease and disability adjusted life years that can be attributed to reduced glomerular filtration rate (GFR). These findings underline the need to evaluate whether screening for chronic kidney disease is effective and if early interventions can reduce the incidence of GFR-attributable adverse events.

Chronic kidney disease (CKD) has a heritable component and is an important global public health problem because of its high prevalence and morbidity.1 We conducted genome-wide association studies (GWAS) to identify susceptibility loci for glomerular filtration rate estimated by serum creatinine (eGFRcrea), cystatin C (eGFRcys), and CKD (eGFRcrea

The reduction of cardiovascular disease risk in kidney failure involves treatment of modifiable risk factors and provision of proven interventions to patients with established disease. Volume status management is key to blood pressure control. Statins are the agents of choice for the treatment of dyslipidemia. Target hemoglobin levels should be achieved using intravenous iron and erythropoietic agents. Combinations of calcium and noncalcium-containing phosphorus binders and vitamin D and its analogues should be used to attain target parathyroid hormone, phosphorus, and calcium phosphorus product levels. beta Blockers and aspirin are recommended in patients with ischemic heart disease and angiotensin-converting enzyme inhibitors (or angiotensin II receptor blockers), and beta blockers are recommended in patients with heart failure with reduced ejection fraction. In patients who require revascularization, studies suggest a survival benefit of coronary artery bypass graft surgery over percutaneous transluminal coronary angioplasty and coronary artery stenting.

A recent report from the Alberta Kidney Disease Network demonstrates that high estimated glomerular filtration rate is associated with an increased risk of all-cause mortality in both young and elderly individuals, as well as in those with and without proteinuria. Potential explanations and implications of these findings are discussed.

There is an extremely high burden of cardiovascular disease (CVD) in patients with renal disease. Both traditional as well as uremia-related factors are contributory. Diagnosis of CVD has limitations in patients with renal disease, and suspicion for the presence of CVD needs to be high even in the absence of classic symptoms. Prevention and management of CVD is similar to the general population but important differences need to be noted.

Individuals with chronic kidney disease (CKD) are more likely to die of cardiovascular causes than progress to end-stage renal disease. A recent report on a large, contemporary cohort highlights the high rates of CKD among patients with acute coronary syndromes, the poor outcomes associated with CKD, and the ongoing gap between evidence and practice in this population.