Bibbins-Domingo K et al. (2006) Renal function and heart failure risk in older black and white individuals: the Health, Aging, and Body Composition Study. Arch Intern Med 166: 1396–1402

Chronic kidney disease increases the risk of heart failure. Both conditions are more likely to affect black individuals than whites. Researchers have used three common methods for measuring kidney function—serum creatinine level, plasma cystatin C level and estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation—to investigate whether the relationship between chronic kidney disease and incident heart failure differs between the two racial groups.

Among a subset of elderly participants from the Health, Aging, and Body Composition Study who had no self-reported history of heart failure (1,124 black and 1,676 white individuals aged between 70 and 79 years), 200 individuals developed heart failure over a mean period of 5.7 years. High cystatin C concentration and low eGFR were associated with heart failure in both black and white participants, but the association was much stronger in the former. The nearly linear association between heart failure and kidney dysfunction in black individuals as measured by cystatin C, and this technique's good sensitivity at higher GFRs, indicate that cystatin C measurement is the most accurate means of assessing risk of heart failure in this racial group.

Elucidating the mechanisms responsible for the stronger association of kidney dysfunction with heart failure in black individuals requires further investigation. The authors suggest that there could be a risk factor common to kidney and heart disease, such as hypertension, that is more severe in those of black ethnic origin.