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Anemia and left ventricular hypertrophy with renal function decline and cardiovascular events in chronic kidney

Jer-Ming Chang1, Szu-Chia Chen, Jiun-Chi Huang

  • 1Division of Nephrology (J-MC, S-CC, J-CH, H-CC); and Division of Cardiology (H-MS), Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine (J-MC, S-CC, J-CH, H-MS), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Renal Care (J-MC, H-CC); and Faculty of Medicine (S-CC, H-MS), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

The American Journal of the Medical Sciences
|February 22, 2013
PubMed

Insights

Anemia and left ventricular hypertrophy (LVH) in chronic kidney disease (CKD) patients independently predict faster kidney function decline and higher cardiovascular event risk. Early assessment aids in identifying high-risk individuals.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Anemia is a frequent complication in chronic kidney disease (CKD).
  • Anemia may initiate or accelerate left ventricular hypertrophy (LVH).
  • The independent association of coexisting anemia and LVH with renal function decline and cardiovascular events in CKD patients requires investigation.

Purpose of the Study:

  • To assess if coexisting anemia and LVH are independently associated with the rate of renal function decline in CKD stages 3 to 5.
  • To determine if coexisting anemia and LVH are independently associated with increased cardiovascular events in CKD stages 3 to 5.

Main Methods:

  • Longitudinal study of 415 CKD patients (stages 3-5).
  • Patients classified into 4 groups based on hemoglobin levels and presence/absence of LVH.
  • Renal function change measured by estimated glomerular filtration rate (eGFR) slope; cardiovascular events defined and analyzed using Cox regression.

Main Results:

  • The eGFR slope was significantly lower in patients with both low hemoglobin and LVH compared to other groups (P ≤ 0.031).
  • Coexisting anemia and LVH were independently associated with a 4.269-fold increased risk of cardiovascular events (HR, 4.269; P = 0.011).

Conclusions:

  • The coexistence of anemia and LVH is independently linked to accelerated renal function decline and adverse cardiovascular outcomes in CKD patients.
  • Serum hemoglobin levels and LVH assessment via echocardiography can identify high-risk CKD patients with poor renal and cardiovascular prognosis.
Abstract

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