The nonlinear relationship between estimated glomerular filtration rate and cardiovascular disease in US adults: a cross-sectional study from NHANES 2007–2018

Background and aimEstimated glomerular filtration rate (eGFR) is a key indicator of kidney function and is associated with numerous health conditions. This study examines the association between eGFR and cardiovascular disease (CVD) risk in a representative cohort of the US adult population.MethodsA cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The study included 31,020 participants aged 20 years and older. The eGFR estimates were calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CVD was defined as a self-reported physician's diagnosis of congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction, or stroke. To assess the association between eGFR and CVD risk, the study employed weighted linear regression and generalized additive models.ResultsThe study revealed a significant non-linear inverse association between eGFR and CVD risk, with a threshold effect observed at 99.3 ml/min/1.73 m². Below this threshold, each 10-unit increase in eGFR was associated with a 13% decrease in the odds of CVD (OR: 0.87, 95% CI: 0.84–0.90, P