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Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease.

Nitta K, Iimuro S, Imai E, Matsuo S, Makino H, Akizawa T, Watanabe T, Ohashi Y, Hishida A - Clin. Exp. Nephrol. (2013)

Bottom Line: LVH was detected in 21.7% of patients at baseline.Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function.Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan, knitta@kc.twmu.ac.jp.

ABSTRACT

Background: Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined.

Methods: We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3-5 CKD. LVH was defined as LVMI>125 g/m2 in male patients and >110 g/m2 in female patients.

Results: We analyzed baseline characteristics in 1185 participants (male 63.7%, female 36.3%). Diabetes mellitus was the underlying disease in 41.3% of patients, and mean age was 61.8±11.1 years. LVH was detected in 21.7% of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95% confidence interval [CI] 0.360-0.916; P=0.020), systolic blood pressure (OR 1.179; 95% CI 1.021-1.360; P=0.025), body mass index (OR 1.135; 95% CI 1.074-1.200; P<0.001), and serum calcium level (OR 0.589; 95% CI 0.396-0.876; P=0.009).

Conclusion: Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

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Related in: MedlinePlus

Relationship between body mass index (BMI) and left ventricular mass index (LVMI) of patients with stage 3–5 CKD. a Female; b male
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Fig3: Relationship between body mass index (BMI) and left ventricular mass index (LVMI) of patients with stage 3–5 CKD. a Female; b male

Mentions: Table 5 shows that the factors associated with LVH were female sex (OR 1.78; 95 % CI 1.308–2.416; P < 0.001), DM (OR 1.66; 95 % CI 1.254–2.186; P < 0.001), dyslipidemia (OR 1.43; 95 % CI 1.007–2.040; P = 0.045), and hypertension (OR 3.73; 95 % CI 1.487–9.376; P = 0.005). Significant clinical factors associated with LVH were systolic BP (OR 1.23; 95 % CI 1.134–1.323; P < 0.001), diastolic BP (OR 1.16; 95 % CI 1.031–1.306; P = 0.014), pulse pressure (OR 1.25; 95 % CI 1.137–1.380; P < 0.001), eGFR (OR 0.98; 95 % CI 0.968–0.9991; P = 0.0004; Fig. 2a, b), BMI (OR 1.15; 95 % CI 1.110–1.199; P < 0.0001; Fig. 3a, b), serum uric acid (OR 1.10; 95 % CI 1.002–1.202; P = 0.046), ACR (OR 1.55; 95 % CI 1.267–1.905; P < 0.001), A1C (OR 1.17; 95 % CI 1.011–1.345; P = 0.035), serum levels of iPTH (OR 1.00; 95 % CI 1.001–1.005; P < 0.001), HDL cholesterol (OR 0.98; 95 % CI 0.971–0.989; P < 0.001), triglyceride (OR 1.00; 95 % CI 1.001–1.003; P < 0.001), calcium (OR 0.56; 95 % CI 0.431–0.720; P < 0.001) and phosphorus (OR 1.23; 95 % CI 1.004–1.515; P = 0.046), and prescription of antihypertensive agents (OR 3.51; 95 % CI 1.601–7.685; P = 0.002).Table 5


Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease.

Nitta K, Iimuro S, Imai E, Matsuo S, Makino H, Akizawa T, Watanabe T, Ohashi Y, Hishida A - Clin. Exp. Nephrol. (2013)

Relationship between body mass index (BMI) and left ventricular mass index (LVMI) of patients with stage 3–5 CKD. a Female; b male
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824297&req=5

Fig3: Relationship between body mass index (BMI) and left ventricular mass index (LVMI) of patients with stage 3–5 CKD. a Female; b male
Mentions: Table 5 shows that the factors associated with LVH were female sex (OR 1.78; 95 % CI 1.308–2.416; P < 0.001), DM (OR 1.66; 95 % CI 1.254–2.186; P < 0.001), dyslipidemia (OR 1.43; 95 % CI 1.007–2.040; P = 0.045), and hypertension (OR 3.73; 95 % CI 1.487–9.376; P = 0.005). Significant clinical factors associated with LVH were systolic BP (OR 1.23; 95 % CI 1.134–1.323; P < 0.001), diastolic BP (OR 1.16; 95 % CI 1.031–1.306; P = 0.014), pulse pressure (OR 1.25; 95 % CI 1.137–1.380; P < 0.001), eGFR (OR 0.98; 95 % CI 0.968–0.9991; P = 0.0004; Fig. 2a, b), BMI (OR 1.15; 95 % CI 1.110–1.199; P < 0.0001; Fig. 3a, b), serum uric acid (OR 1.10; 95 % CI 1.002–1.202; P = 0.046), ACR (OR 1.55; 95 % CI 1.267–1.905; P < 0.001), A1C (OR 1.17; 95 % CI 1.011–1.345; P = 0.035), serum levels of iPTH (OR 1.00; 95 % CI 1.001–1.005; P < 0.001), HDL cholesterol (OR 0.98; 95 % CI 0.971–0.989; P < 0.001), triglyceride (OR 1.00; 95 % CI 1.001–1.003; P < 0.001), calcium (OR 0.56; 95 % CI 0.431–0.720; P < 0.001) and phosphorus (OR 1.23; 95 % CI 1.004–1.515; P = 0.046), and prescription of antihypertensive agents (OR 3.51; 95 % CI 1.601–7.685; P = 0.002).Table 5

Bottom Line: LVH was detected in 21.7% of patients at baseline.Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function.Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan, knitta@kc.twmu.ac.jp.

ABSTRACT

Background: Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined.

Methods: We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3-5 CKD. LVH was defined as LVMI>125 g/m2 in male patients and >110 g/m2 in female patients.

Results: We analyzed baseline characteristics in 1185 participants (male 63.7%, female 36.3%). Diabetes mellitus was the underlying disease in 41.3% of patients, and mean age was 61.8±11.1 years. LVH was detected in 21.7% of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95% confidence interval [CI] 0.360-0.916; P=0.020), systolic blood pressure (OR 1.179; 95% CI 1.021-1.360; P=0.025), body mass index (OR 1.135; 95% CI 1.074-1.200; P<0.001), and serum calcium level (OR 0.589; 95% CI 0.396-0.876; P=0.009).

Conclusion: Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

Show MeSH
Related in: MedlinePlus