Related Experiment Video
Updated: Apr 5, 2026
Author Spotlight: Advancing Thymic Epithelial Cells and T-Cell Research with Human Thymic Organoids
Published on: October 4, 2024
Estimated GFR and Subsequent Higher Left Ventricular Mass in Young and Middle-Aged Adults With Normal Kidney
Nisha Bansal1, Feng Lin2, Eric Vittinghoff2
1University of Washington, Kidney Research Institute, Seattle, WA.
Insights
Lower kidney function (eGFRcys 60-75) and rapid eGFR decline are linked to higher left ventricular mass index (LVMI) in adults with preserved kidney function. Further research is needed to understand these associations.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for cardiovascular events and mortality in chronic kidney disease (CKD) patients.
- The relationship between declining glomerular filtration rate (GFR) and left ventricular mass index (LVMI) is not well understood in young and middle-aged adults with normal kidney function.
Purpose of the Study:
- To investigate the association between cystatin C-based estimated GFR (eGFRcys) and LVMI in adults with preserved kidney function.
- To examine the link between a rapid decline in eGFRcys and subsequent LVMI.
Main Methods:
- An observational study analyzed 2,410 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort.
- Participants had an eGFRcys > 60mL/min/1.73m(2) at year 15 and underwent echocardiography at year 25.
- eGFRcys at year 15 and rapid decline (>3% per year over 5 years) were used as predictors, with LVMI as the outcome, adjusting for multiple confounders.
Main Results:
- A lower eGFRcys range (60-75mL/min/1.73m(2)) was associated with a significantly greater LVMI (5.63 g/m(2.7) higher; P=0.02) compared to eGFRcys > 90mL/min/1.73m(2).
- Rapid decline in eGFRcys was also associated with higher LVMI (β=1.48; P=0.03) compared to those without rapid decline.
- No significant association was found for eGFRcys between 76-90mL/min/1.73m(2).
Conclusions:
- In young to middle-aged adults with preserved kidney function, eGFRcys levels of 60-75mL/min/1.73m(2) and a rapid decline in eGFRcys are linked to increased LVMI.
- The study highlights a potential cardiovascular risk associated with subtle kidney function decline even in individuals with seemingly normal GFR.
- Further research is warranted to elucidate the underlying mechanisms connecting reduced eGFRcys and elevated LVMI in this population.
Background:
Left ventricular hypertrophy is common and is associated with cardiovascular events and death among patients with known chronic kidney disease. However, the link between reduced glomerular filtration rate (GFR) and left ventricular mass index (LVMI) remains poorly explored among young and middle-aged adults with preserved kidney function. In this study, we examined the association of cystatin C-based estimated GFR (eGFRcys) and rapid decline in eGFR with subsequent LVMI.
Study Design:
Observational study.
Setting & Participants:
We included 2,410 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort with eGFRcys > 60mL/min/1.73m(2) at year 15 and who had an echocardiogram obtained at year 25.
Predictor:
eGFRcys at year 15 and rapid decline in eGFRcys (defined as >3% per year over 5 years from years 15 to 20).
Outcome:
LVMI measured at year 25.
Measurements:
We adjusted for age, sex, race, diabetes, body mass index, low- and high-density lipoprotein cholesterol levels, cumulative systolic blood pressure, and albuminuria.
Results:
Mean age was 40±4 (SD) years, 58% were women, and 43% were black. After 10 years of follow-up, mean LVMI was 39.6±13.4g/m(2.7). Compared with eGFRcys > 90mL/min/1.73m(2) (n = 2,228), eGFRcys of 60 to 75mL/min/1.73m(2) (n = 29) was associated with 5.63 (95% CI, 0.90-10.36) g/m(2.7) greater LVMI (P = 0.02), but there was no association of eGFRcys of 76 to 90mL/min/1.73m(2) (n = 153) with LVMI after adjustment for confounders. Rapid decline in eGFRcys was associated with higher LVMI compared with participants without a rapid eGFRcys decline (β coefficient, 1.48; 95% CI, 0.11-2.83; P = 0.03) after adjustment for confounders.
Limitations:
There were a limited number of participants with eGFRcys of 60 to 90mL/min/1.73m(2).
Conclusions:
Among young and middle-aged adults with preserved kidney function, eGFRcys of 60 to 75mL/min/1.73m(2) and rapid decline in eGFRcys were significantly associated with subsequently higher LVMI. Further studies are needed to understand the mechanisms that contribute to elevated LVMI in this range of eGFRcys.
