Associations between kidney function and subclinical cardiac abnormalities in CKD

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.