Chronic kidney disease (CKD) frequently coexists with coronary artery disease (CAD) and may influence subsequent cardiovascular outcomes, yet its detection across global populations remains variable. A multinational analysis published in the Journal of the American College of Cardiology examined the burden of CKD and the clinical relevance of estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio (UACR) in patients with CAD.

The study evaluated 4,548 adults aged 18–80 years across 14 countries, with men accounting for 79.6% of the cohort. Kidney function was assessed between 6 and 24 months following CAD diagnosis. Complete renal and treatment data were available for 3,865 individuals, and outcome data over a median follow-up of 1 year were obtained for 3,577 patients.

Using Kidney Disease: Improving Global Outcomes (KDIGO) criteria, CKD was identified in 32% of patients, with 19.7% classified as low–moderate risk, 6.9% as high risk, and 5.6% as very high risk. Notably, more than half of CKD cases (51.3%) would not have been detected without UACR measurement. The composite cardiovascular endpoint occurred in 7.9% of patients, with the highest event rates observed in the KDIGO high-risk category. These associations were independent of other clinical factors and were apparent early after assessment.

These findings indicate that CKD is common among patients with CAD and that combining eGFR with UACR captures a substantial proportion of otherwise unrecognized cases.