Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease
<i>Background and Objectives</i>: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardia...
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MDPI AG
2024-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/1/127 |
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| author | Antonio Lacquaniti Fabrizio Ceresa Susanna Campo Francesco Patané Paolo Monardo |
| author_facet | Antonio Lacquaniti Fabrizio Ceresa Susanna Campo Francesco Patané Paolo Monardo |
| author_sort | Antonio Lacquaniti |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardiac structures characterizing patients with CKD, assessing the independent association between echocardiographic parameters and the risk of decline in renal function. <i>Materials and Methods:</i> In total, 160 patients with CKD were studied. All patients underwent an echocardiographic exam and 99mTc-DTPA renal scintigraphy to measure the GFR. After the baseline assessments, patients were followed prospectively for 12 months, or until the endpoint achievement, defined as a worsening in renal function (doubling of baseline serum creatinine, GFR decline ≥25%, the start of dialysis). <i>Results:</i> Patients with GFR values of 34.8 ± 15 mL/min, identifying stages III–IV of CKD, were associated with high levels of left ventricular mass index (LVMi) (101.9 ± 12.2 g/m<sup>2</sup>), which was related to proteinuria, systolic blood pressure, and pulmonary artery systolic pressure in a multiple regression model. During the observational period, 26% of patients reached the endpoint. Regression analysis revealed LVMi as a predictor of change in renal function after adjusting for kidney and cardiac risk factors. Multiple Cox regression indicated that an increase in LVMi was associated with a 12% increased risk of kidney disease progression (HR: 1.12; 95% CI: 1.04–1.16; <i>p</i> = 0.001). <i>Conclusions:</i> In patients with CKD, high LVMi represents an independent predictor of the progressive decline of the renal function, until the start of renal replacement therapy. Echocardiography can help identify patients at high risk for renal disease worsening in patients with CKD independently of clinical cardiac involvement. |
| first_indexed | 2024-03-08T10:41:24Z |
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| language | English |
| last_indexed | 2024-03-08T10:41:24Z |
| publishDate | 2024-01-01 |
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| series | Medicina |
| spelling | doaj.art-9060554085ae4634b36ea54ab46ede682024-01-26T17:35:30ZengMDPI AGMedicina1010-660X1648-91442024-01-0160112710.3390/medicina60010127Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney DiseaseAntonio Lacquaniti0Fabrizio Ceresa1Susanna Campo2Francesco Patané3Paolo Monardo4Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, ItalyDepartment of Thoracic and Cardiovascular Surgery, Papardo Hospital, 98158 Messina, ItalyNephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, ItalyDepartment of Thoracic and Cardiovascular Surgery, Papardo Hospital, 98158 Messina, ItalyNephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy<i>Background and Objectives</i>: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardiac structures characterizing patients with CKD, assessing the independent association between echocardiographic parameters and the risk of decline in renal function. <i>Materials and Methods:</i> In total, 160 patients with CKD were studied. All patients underwent an echocardiographic exam and 99mTc-DTPA renal scintigraphy to measure the GFR. After the baseline assessments, patients were followed prospectively for 12 months, or until the endpoint achievement, defined as a worsening in renal function (doubling of baseline serum creatinine, GFR decline ≥25%, the start of dialysis). <i>Results:</i> Patients with GFR values of 34.8 ± 15 mL/min, identifying stages III–IV of CKD, were associated with high levels of left ventricular mass index (LVMi) (101.9 ± 12.2 g/m<sup>2</sup>), which was related to proteinuria, systolic blood pressure, and pulmonary artery systolic pressure in a multiple regression model. During the observational period, 26% of patients reached the endpoint. Regression analysis revealed LVMi as a predictor of change in renal function after adjusting for kidney and cardiac risk factors. Multiple Cox regression indicated that an increase in LVMi was associated with a 12% increased risk of kidney disease progression (HR: 1.12; 95% CI: 1.04–1.16; <i>p</i> = 0.001). <i>Conclusions:</i> In patients with CKD, high LVMi represents an independent predictor of the progressive decline of the renal function, until the start of renal replacement therapy. Echocardiography can help identify patients at high risk for renal disease worsening in patients with CKD independently of clinical cardiac involvement.https://www.mdpi.com/1648-9144/60/1/127left ventricular mass indexbrain natriuretic peptidechronic kidney disease progressionnatriuretic peptides |
| spellingShingle | Antonio Lacquaniti Fabrizio Ceresa Susanna Campo Francesco Patané Paolo Monardo Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease Medicina left ventricular mass index brain natriuretic peptide chronic kidney disease progression natriuretic peptides |
| title | Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease |
| title_full | Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease |
| title_fullStr | Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease |
| title_full_unstemmed | Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease |
| title_short | Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease |
| title_sort | left ventricular mass index predicts renal function decline in patients with chronic kidney disease |
| topic | left ventricular mass index brain natriuretic peptide chronic kidney disease progression natriuretic peptides |
| url | https://www.mdpi.com/1648-9144/60/1/127 |
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