Why do young people with chronic kidney disease die early?

Table 1 Adjusted hazard ratio for death from any cause and cardiovascular events in 1120295 adults according to estimated glomerular filtration rate

Estimated GFR (mL/min per 1.73 m2)	Death fromany cause	Any Cardiovascular event
≥ 60	1	1
45-59	1.2 (1.1-1.2)	1.4 (1.4-1.5)
30-44	1.8 (1.7-1.9)	2.0 (1.9-2.1)
15-29	3.2 (3.1-3.4)	2.8 (2.6-2.9)
< 15	5.9 (5.4-6.5)	3.4 (3.1-3.8)

Adjusted hazard ratio with 95%confidence intervals given in parentheses. Data adjusted for age, gender, presence or absence of prior coronary heart disease, prior chronic heart failure, prior ischaemic stroke or ischaemic attack, prior peripheral arterial disease, diabetes mellitus, hypertension, dyslipidaemia, cancer, liver disease, chronic lung disease. After Go et al[1], 2004.

Table 2 Promoters and inhibitors of vascular calcification

Promoters of vascular calcification	Inhibitors of vascular calcification
Traditional factors	Circulating inhibitors
Older age, male gender, hypertension, diabetes, smoking, high LDL cholesterol, low HDL cholesterol, genetic predisposition	Fetuin-A, bone morphogenetic protein-7, parathyroid hormone-related peptide, HDL cholesterol, magnesium,
Uraemia-related factors
Uraemia, hyperphosphatemia,	Locally acting inhibitors
increased Ca x P product, exogenous vitamin D therapy, elevated parathyroid hormone level, duration of dialysis, calcium load and hypercalcaemia, chronic inflammation, warfarin, elevated leptin levels	Matrix Gla protein, α-klotho, osteopontin, pyrophosphate, osteoprotegerin, genetic predisposition

Adapted from Qunibi[87], 2005. HDL: High-density lipoprotein.