Nitta Kosaku, Iimuro Satoshi, Imai Enyu, Matsuo Seiichi, Makino Hirofumi, Akizawa Tadao, Watanabe Tsuyoshi, Ohashi Yasuo, Hishida Akira
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, 162-8666, Japan.
Teikyo Academic Research Center, Teikyo University, Tokyo, Japan.
Clin Exp Nephrol. 2019 Jan;23(1):85-98. doi: 10.1007/s10157-018-1605-z. Epub 2018 Jun 27.
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 pre-dialysis period has not been fully examined.
We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study to identify factors that are associated with increased LVMI in patients with stage 3-5 CKD.
We analyzed the baseline characteristics in 1088 participants (male 63.8%, female 36.2%). Diabetes mellitus was the underlying disease in 41.7% of the patients, and mean age was 61.8 ± 11.1 years. LVH was detected in 23.4% of the patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease [odds ratio (OR) 2.364; 95% confidence interval ([CI) 1.463-3.822; P = 0.0004], body mass index (OR 1.108; 95% CI 1.046-1.173; P = 0.0005), systolic blood pressure (OR 1.173; 95% CI 1.005-1.369; P = 0.0433), urinary albumin (OR 1.425; 95% CI 1.028-1.974; P = 0.0333), and serum total cholesterol level (OR 0.994; 95% CI 0.989-0.999; P = 0.0174).
The 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.
尽管左心室肥厚（LVH）已被确认为慢性肾脏病（CKD）中心血管事件的预测指标，但透析前期LVH患病率与CKD分期之间的关系尚未得到充分研究。
我们在日本慢性肾脏病队列（CKD-JAC）研究的横断面队列中测量了左心室质量指数（LVMI），以确定与3-5期CKD患者LVMI升高相关的因素。
我们分析了1088名参与者的基线特征（男性63.8%，女性36.2%）。41.7%的患者基础疾病为糖尿病，平均年龄为61.8±11.1岁。基线时23.4%的患者检测到LVH。通过多因素逻辑分析，LVH的独立危险因素为心血管疾病病史[比值比（OR）2.364；95%置信区间（CI）1.463-3.822；P = 0.0004]、体重指数（OR 1.108；95%CI 1.046-1.173；P = 0.0005）、收缩压（OR 1.173；95%CI 1.005-1.369；P = 0.0433）、尿白蛋白（OR 1.425；95%CI 1.028-1.974；P = 0.0333）和血清总胆固醇水平（OR 0.994；95%CI 0.989-0.999；P = 0.0174）。
CKD-JAC研究的横断面基线数据揭示了肾功能减退患者LVH与危险因素之间的关联。需要对CKD-JAC队列进行进一步的纵向分析，以评估LVH在CKD患者中的预后价值。
