Original Investigation Parental History of Premature Cardiovascular Disease, Estimated GFR, and Rate of Estimated GFR Decline: Results From the Aerobics Center Longitudinal Study

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 w2 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 6 12.9 vs 74.8 6 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 20.47 vs 20.41 mL/min/1.73 m 2 ; P 5 0.06). Limitations: w70% 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.