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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Body Mass Index, Left Ventricular Mass Index and Cardiovascular Events in Chronic Kidney Disease
Szu-Chia Chen1, Jiun-Chi Huang2, Yi-Chun Tsai3
1Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
Insights
Low body mass index (BMI) combined with high left ventricular mass index (LVMI) significantly increases cardiovascular event risk in chronic kidney disease (CKD) patients. This finding highlights a critical risk factor for cardiovascular outcomes in CKD stages 3-5.
Area of Science:
- Nephrology
- Cardiology
- Clinical Research
Background:
- Obesity and left ventricular hypertrophy are common in chronic kidney disease (CKD).
- The relationship between body mass index (BMI), left ventricular mass index (LVMI), and cardiovascular outcomes in CKD patients remains unclear.
- This study investigated the independent association of combined BMI and LVMI with cardiovascular events in CKD stages 3-5.
Purpose of the Study:
- To determine if the combination of BMI and LVMI is independently associated with cardiovascular events in patients with CKD stages 3-5.
- To assess the risk stratification potential of combined BMI and LVMI in this patient population.
Main Methods:
- 523 patients with CKD stages 3-5 were enrolled from an outpatient department.
- Patients were categorized into four groups based on sex-specific median BMI and LVMI.
- Cardiovascular events were comprehensively defined, and relative risk was analyzed using Cox-regression.
Main Results:
- A combination of low BMI and high LVMI showed a significantly higher risk of cardiovascular events compared to high BMI and low LVMI.
- This association remained significant in both unadjusted (HR=3.178) and multivariable models (HR=3.553) after adjusting for various factors.
- The findings were statistically significant (P < 0.001 and P = 0.004, respectively).
Conclusions:
- The combination of low BMI and high LVMI is independently associated with adverse cardiovascular events in patients with CKD stages 3-5.
- This specific risk profile warrants attention for cardiovascular risk management in CKD patients.
Background:
Obesity and left ventricular hypertrophy are prevalent in chronic kidney disease (CKD), but the association of body mass index (BMI) and left ventricular mass index (LVMI) with cardiovascular outcomes in patients with CKD is unclear. This study was designed to assess whether the combination of BMI and LVMI is independently associated with cardiovascular events in patients with CKD stages 3-5.
Methods:
From the outpatient department, 523 patients with CKD who received echocardiographic examination were enrolled. The patients under study were classified into 4 groups according to sex-specific median BMIs and LVMIs. Cardiovascular events were defined as cardiovascular death, hospitalization for unstable angina, nonfatal myocardial infarction, sustained ventricular arrhythmia, hospitalization for congestive heart failure, transient ischemia attack and stroke. The relative cardiovascular event risk was analyzed using Cox-regression methods.
Results:
The patients were stratified into 4 groups according to sex-specific median BMIs (men: 25.2 kg/m(2); women: 24.9 kg/m(2)) and LVMIs (men: 140.1g/m(2); women: 131.6g/m(2)). A combination of low BMI and high LVMI (versus the combination of high BMI and low LVMI) was significantly associated with cardiovascular events in an unadjusted model (hazard ratio [HR] = 3.178; 95% confidence interval [CI]: 1.645-6.140; P < 0.001) and in a multivariable model after adjustment for demographic, clinical and biochemical characteristics and medications (HR = 3.553; 95% CI: 1.494-8.450; P = 0.004).
Conclusions:
The findings showed that the combination of low BMI and high LVMI was associated with adverse cardiovascular events in patients with CKD stages 3-5.
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