Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease.

BACKGROUND

Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined.

METHODS

We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3-5 CKD. LVH was defined as LVMI>125 g/m2 in male patients and >110 g/m2 in female patients.

RESULTS

We analyzed baseline characteristics in 1185 participants (male 63.7%, female 36.3%). Diabetes mellitus was the underlying disease in 41.3% of patients, and mean age was 61.8±11.1 years. LVH was detected in 21.7% of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95% confidence interval [CI] 0.360-0.916; P=0.020), systolic blood pressure (OR 1.179; 95% CI 1.021-1.360; P=0.025), body mass index (OR 1.135; 95% CI 1.074-1.200; P<0.001), and serum calcium level (OR 0.589; 95% CI 0.396-0.876; P=0.009).

CONCLUSION

Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.