Association Between Left Ventricular Geometry and Renal Outcomes in Patients With Chronic Kidney Disease: Findings From Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease Study

被引：8

作者：

Suh, Sang Heon

Oh, Tae Ryom

Choi, Hong Sang

Kim, Chang Seong

Bae, Eun Hui

Oh, Kook-Hwan

Lee, Joongyub

Jung, Ji Yong

Lee, Kyu-Beck

Ma, Seong Kwon

Kim, Soo Wan

机构：

[1] Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju

[2] Department of Internal Medicine, Seoul National University Hospital, Seoul

[3] Department of Prevention and Management, School of Medicine, Inha University, Incheon

[4] Division of Nephrology, Department of Internal Medicine, Gachon University of Gil Medical Center, Incheon

[5] Department of Internal Medicine, School of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University Seoul, Seoul

来源：

FRONTIERS IN CARDIOVASCULAR MEDICINE | 2022年 / 9卷

基金：

新加坡国家研究基金会;

关键词：

chronic kidney disease; left ventricular geometry; left ventricular hypertrophy; relative wall thickness; renal outcome; all-cause mortality; END-POINT REDUCTION; ANTIHYPERTENSIVE TREATMENT; CONVENTIONAL HEMODIALYSIS; CARDIOVASCULAR OUTCOMES; PROGNOSTIC IMPLICATIONS; LOSARTAN INTERVENTION; FOLLOW-UP; HYPERTROPHY; MASS; HYPERTENSION;

D O I：

10.3389/fcvm.2022.848692

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundThe impact of left ventricular (LV) geometry on the renal outcomes in patients with chronic kidney disease (CKD) has not been established yet. We aimed to investigate the association of LV geometry with renal outcomes and all-cause mortality in patients with pre-dialysis CKD. MethodsA total of 2,144 subjects from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) were categorized by LV geometry, which was defined by LV mass index and relative wall thickness [normal geometry, concentric remodeling, eccentric hypertrophy (eLVH), and concentric hypertrophy (cLVH)]. Study outcomes were composite renal events [decline of kidney function (the first occurrence of > 50% decline of eGFR or doubling of serum creatinine from the baseline) and onset of ESRD (initiation of dialysis or kidney transplantation) during follow-up periods)] and all-cause mortality. ResultsCox regression analysis revealed that eLVH [adjusted hazard ratio (HR) 1.498, 95% confidence interval (CI) 1.197-1.873] and cLVH (adjusted HR 1.289, 95% CI 1.011-1.643) were associated with increased risk of composite renal events, whereas concentric remodeling (adjusted HR 1.881, 95% CI 1.135-3.118) and cLVH (adjusted HR 2.216, 95% CI 1.341-3.664) were associated with increased risk of all-cause mortality. Sensitivity analyses confirmed that concentric remodeling (adjusted HR 1.993, 95% CI 1.197-3.368) and eLVH (adjusted HR 1.588, 95% CI 1.261-2.001) are independently associated with all-cause mortality and composite renal events, respectively. ConclusionIn conclusion, we report that LV geometry is significantly associated with adverse renal outcomes and all-cause mortality in patients with pre-dialysis CKD. Echocardiographic determination of LV geometry may help the early identification for the patients with high risk of CKD progression.

引用

页数：11

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