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Minor renal dysfunction: an emerging independent cardiovascular risk factor
  1. E Ritz
  1. Correspondence to:
    Professor Eberhard Ritz, Bergheimer Strasse, 56a Heidelberg, 69115, Germany;

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Because of the excessive cardiac risk, treating a patient with renal dysfunction should no longer be regarded as primary, but rather as secondary prevention

Following the seminal observation of Lindner and colleagues1 on the excessive cardiovascular mortality in patients with end stage renal disease on renal replacement therapy, this observation has been repeatedly confirmed. It is currently known that in patients on renal replacement therapy the relative risk of dying from cardiac causes is higher by a factor of 10–100, depending on age.2

It has only recently been recognised that even minor renal dysfunction, as reflected by an increase in urinary albumin excretion and/or a decrease in glomerular filtration rate, is an independent cardiovascular risk factor3 which should be added to the known factors contributing to the Framingham risk score.

This has again been confirmed and extended by the present study of Santopinto and colleagues,3 published in this issue of Heart, who report on an impressively large prospective multicentre observational study covering 11 774 …

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