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Echocardiographic parameters and cardiovascular disease in Japanese- and US-based CKD cohorts

Carl P Walther1, Sankar D Navaneethan2

  • 1Section of Nephrology, Selzman Institute for Kidney Health, Baylor College of Medicine, Houston, Texas, USA.

Kidney International
|April 21, 2023
PubMed

Insights

Japanese and US patients with chronic kidney disease have similar prevalence but differing outcomes. Left ventricular differences largely explain worse cardiovascular outcomes in US patients, highlighting needs for precision nephrology.

Area of Science:

  • Nephrology
  • Cardiology
  • Population Health

Background:

  • Chronic kidney disease (CKD) affects Japanese and US populations similarly in prevalence.
  • Significant disparities exist in clinical outcomes between these populations.

Purpose of the Study:

  • To compare cardiovascular outcomes between a Japanese and a US CKD cohort.
  • To investigate the role of cardiac structure and function in explaining outcome differences.

Main Methods:

  • Secondary analysis of CKD cohorts from Japan and the US.
  • Mediation analysis to assess the contribution of left ventricular parameters.

Main Results:

  • The US CKD cohort exhibited significantly worse cardiovascular outcomes compared to the Japanese cohort.
  • Mediation analysis indicated that differences in left ventricular structure and function accounted for the majority of the observed outcome disparity.

Conclusions:

  • Cardiac remodeling and dysfunction are key mediators of worse cardiovascular outcomes in US CKD patients.
  • Findings support the need for tailored interventions in precision nephrology and population health strategies.

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