Parental history of premature cardiovascular disease, estimated GFR, and rate of estimated GFR decline: results from the Aerobics Center Longitudinal Study

Abstract

Background: Despite cardiovascular disease (CVD) and chronic kidney disease sharing similar causes and interplay, it is unknown if a broader relationship between these diseases exists across generations. We investigated the association between parental CVD history and estimated glomerular filtration rate (eGFR) in the community.

Study design: Cross-sectional and longitudinal analyses.

Setting & participants: 13,241 community-based adults with serum creatinine measurement and follow-up visits (from 1-8 visits ~2 years apart) from the Aerobics Center Longitudinal Study.

Predictors: Premature parental CVD history (before age 50 years).

Outcomes: eGFR, decreased eGFR (<60 mL/min/1.73 m(2)), and rate of eGFR decline.

Measurements: Information for parental history was collected by protocol-standardized questionnaires. eGFR was assessed with serum creatinine.

Results: 3,339 (25.2%) participants reported a history of parental CVD. Individuals with parental CVD had significantly lower eGFRs compared with those without parental CVD (69.4 ± 12.9 vs 74.8 ± 14.2 mL/min/1.73 m(2); P<0.001). After multivariable adjustment, parental CVD was associated independently with higher odds of having decreased eGFR (adjusted OR, 1.68; 95% CI, 1.52-1.86). Random-coefficient models showed that individuals with parental CVD had a faster decline in eGFR compared with those without parental CVD (sex- and ethnicity-adjusted annual change of -0.47 vs -0.41 mL/min/1.73 m(2); P=0.06).

Limitations: ~70% of participants did not attend a second examination.

Conclusions: Parental history of CVD was associated with lower baseline eGFR, higher odds of decreased eGFR, and a nominally faster rate of eGFR decline in the offspring. Such findings may imply previously unrecognized cross-generational links between both diseases and be of support in community screening programs.

Keywords: Aerobics Center Longitudinal Study (ACLS); Cardiovascular disease (CVD); chronic kidney disease (CKD); glomerular filtration rate (GFR); heart; kidney; kidney disease progression; parental history; random-coefficient model; renal function; risk factor.