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Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

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Published on: June 16, 2014

Associations between kidney function and subclinical cardiac abnormalities in CKD.

Meyeon Park1, Chi-yuan Hsu, Yongmei Li

  • 1Division of Nephrology, University of California, 521 Parnassus Avenue, San Francisco, CA 94143, USA. . meyeon.park@ucsf.edu

Journal of the American Society of Nephrology : JASN
|September 1, 2012
PubMed
Summary

Reduced kidney function in chronic kidney disease (CKD) is linked to abnormal heart structure, specifically left ventricular hypertrophy (LVH). Lower estimated glomerular filtration rate (eGFR) significantly increases the odds of LVH and altered cardiac geometry.

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Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Heart failure is a frequent complication of chronic kidney disease (CKD), carrying a high mortality risk.
  • The relationship between estimated glomerular filtration rate (eGFR) stages and cardiac structure/function in patients without diagnosed heart failure is not well-established.

Purpose of the Study:

  • To investigate the association between different stages of eGFR and changes in cardiac structure and function.
  • To analyze these associations in a cohort of patients with CKD but without known heart failure.

Main Methods:

  • Cross-sectional analysis of 3487 participants from the Chronic Renal Insufficiency Cohort Study.
  • Estimated GFR using cystatin C.
  • Assessed left ventricular hypertrophy (LVH) and geometry via echocardiography.

Main Results:

  • Prevalence of LVH increased with declining eGFR: 32% (≥60), 48% (45-59), 57% (30-44), and 75% (<30 ml/min/1.73 m²).
  • eGFR <30 ml/min/1.73 m² was associated with a twofold higher odds of LVH (OR=2.20) and abnormal LV geometry compared to eGFR ≥60 ml/min/1.73 m².
  • eGFR 30-44 ml/min/1.73 m² also showed significant associations with LVH and abnormal LV geometry.

Conclusions:

  • Reduced kidney function in CKD is associated with abnormal cardiac structure, particularly LVH and altered LV geometry.
  • No significant associations were found between kidney function and systolic or diastolic dysfunction after adjusting for confounders.
  • These findings highlight the impact of declining kidney function on cardiac remodeling in CKD patients.