Is left ventricular hypertrophy a powerful predictor of progression to dialysis in chronic kidney disease?

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Ernesto PaolettiGiuseppe Cannella

Abstract

The role of cardiovascular factors in predicting renal outcome has not been extensively elucidated. Herein, we report a prospective evaluation of the impact of left ventricular hypertrophy (LVH) on outcome in non-diabetic patients with chronic kidney disease (CKD). We studied 144 patients (99 men; age 62±14 years) with stage 3-4 CKD, with baseline assessment of left ventricular mass index (LVMi) by echocardiography, estimated glomerular filtration rate (eGFR) by MDRD equation, 24-h blood pressure profile and 24-h proteinuria. Combined end point was progression to ESRD requiring dialysis, or death within 5 years. Forty-nine patients (34%) progressed to dialysis, 24 (17%) died, 57 (39%) were dialysis-free after 5 years and 14 were lost to follow-up. Multivariate Cox proportional hazards analysis showed that increased LVMi (HR 1.28, 95% CI 1.17-1.40 for each 10-g/m2 increase, P<0.0001) and reduced eGFR (5% risk increase for each 1-mL/min reduction, P=0.027) were the significant predictors of the combined end point in stage 3 CKD patients, whereas LVMi proved to be the only significant predictor of the combined end point in patients with stage 4 CKD (HR 1.19, 95% CI 1.09-1.31, P<0.0001). The same analysis showed that LVMi was the o...Continue Reading

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Citations

May 19, 2012·International Journal of Biological Sciences·Peng HuYuan Han Qin
Nov 30, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ernesto Paoletti, Carmine Zoccali
Feb 22, 2013·The American Journal of the Medical Sciences·Jer-Ming ChangHung-Chun Chen
Dec 17, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Ernesto PaolettiRoberto Minutolo
Aug 24, 2011·International Journal of Nephrology·Kathryn K StevensAlan G Jardine
Oct 17, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ernesto PaolettiGiacomo Garibotto
Mar 20, 2015·European Journal of Clinical Investigation·Esther de BeusUNKNOWN SMART Study Group
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Dec 3, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Yuhree KimJosef Coresh
Feb 9, 2013·American Journal of Hypertension·Maura RaveraErnesto Paoletti
Feb 6, 2013·American Journal of Hypertension·Szu-Chia ChenHung-Chun Chen
May 13, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Costantino MancusiMaria Angela Losi
Dec 15, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Thomas ParkerRichard J Glassock

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