Kidney Week

Abstract: SA-PO776

Longitudinal Relationship of Left Ventricular Hypertrophy with Cardiovascular Events in CKD

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Wang, Jinwei, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BEIJING, China

Jinwei Wang,

• Zhang, Luxia, Peking University Institute of Nephrology, Beijing, China

Luxia Zhang,

• He, Kevin, Kidney Epidemiology and Cost Center, University of Michgian, Ann Arbor, Michigan, United States

Kevin He,

• Zhao, Minghui, Reanl division, Peking University First Hospital,, Beijing, China

Minghui Zhao,

Group or Team Name

• the Chinese Cohort Study of Chronic Kidney Disease

Background

We aimed to evaluate the relationship between left ventricular (LV) hypertrophy and adverse cardiovascular (CV) events among patients with chronic kidney disease (CKD).

Methods

Based on the Chinese Cohort Study of CKD (n=3499), 2000 participants with interpretable echocardiograms, complete relevant clinical data and without a baseline CV disease history were enrolled in the study. LV mass was calculated using the area-length method and indexed to height^2.7. CV events included incident acute myocardial infarction, unstable angina, hospitalization for congestive heart failure, cerebrovascular events and peripheral vascular diseases. The population was followed-up until occurrence of CV events or by June 30, 2017. Cox proportional hazards regression model was used to estimate the relationship between the exposure and outcomes.

Results

The mean age of the population was 47.2±13.7 years, with 56.4% of males. The mean level of estimated glomerular filtration rate (eGFR) was 52.9±31.3ml/min/1.73m². The proportions of CKD stages 1, 2, 3a, 3b and 4 were 16.8%, 17.5%, 14.9%, 23.3% and 27.7%, respectively. Mean level of LV mass/ height^2.7 was 39.7±12.7g/m^2.7, with the proportion of LV hypertrophy (LV mass/height^2.7≥47g/m^2.7 in women and ≥50 g/m^2.7 in men) being 17.9%. After a median follow-up of 4.45(inter-quartile range: 3.76-5.05) years, 89 CV events occurred, with an incidence rate of 1.03 per 100 person-years among total patients with CKD, 2.23 per 100 person-years among those with LV hypertrophy and 0.78 per 100 person-years among those without LV hypertrophy (log-rank p-value<0.001). LV hypertrophy or a standard deviation increase in LV mass/ height^2.7 was significantly associated with increased risk of CV events after adjustment for traditional CV risk factors, albuminuria and eGFR. The hazard ratios and 95% confidence interval were 1.78(1.12-2.81) and 1.40(1.19-1.66), respectively. Sensitivity analysis among those with chronic glomerular nephritis or excluding congestive heart failure from the CV events showed consistent results.

Conclusion

LV hypertrophy is independently associated with increased risk of CV events among patients with CKD. Further studies are needed to evaluate the clinical effectiveness of screening high risk population among patients with CKD by using LV hypertrophy.

Funding

• Government Support - Non-U.S.