Abstract: TH-PO472

Left Ventricular Geometry in Type 2 Diabetic Patients with Kidney Disease: Predictive Factors Klotho and FGF23

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Silva, Ana Paula, CHA, Faro, Portugal
  • Mendes, Filipa B., Centro Hospitalar do Algarve, Faro, Portugal
  • Neves, Pedro Leao, CHA, Faro, Portugal
Background

Chronic Kidney Disease (CKD) is known to induce a cardiac overload that reconfigures the architecture and physiology of the myocardium, inducing hypertrophy and fibrosis. Those alterations begin in the early stages of the disease and aggravate as renal functions declines .
The this work we evaluated a population of CKD patients to ascertain the potential use of plasmatic Klotho, FGF23 or both as markers for CKD-induced cardiac disease.

Methods

This prospective cohort study was conducted in our outpatient diabetic nephropathy (DN) clinic from 2012 to 2016.
For this study we included one hundred and seven (107) patients with stage 2-3 CKD. The mean age was 57.2±7.1 years and the mean LVMI level was 99.31±23.45 g/m2.
LVH and RWT were used to categorize LV geometry: normal (no LVH and normal RWT), eccentric hypertrophy (LVH and normal RWT), and concentric hypertrophy (LVH and increased RWT). Patients were classified as having LVH if they had LVMI 100 g/m2 in women and 131 g/m2 in men , and RWT was considered to be increased if .0.45 .

Results

Multinomial regression analysis demonstrated that diminished eGFR (OR=0.959; 95% IC;0.921 – 0.999;p=0.043)and elevated P (OR=2.859;95%IC; 2.238 – 5.693; p=0.003) levels were associated with a greater risk of Eccentric Hypertrophy but not with Concentric Hypertrophy. On contrary, low Klotho (OR=0.737; 95% IC; 0.603 – 0.972;p=0.031 ) and higher FGF-23 (OR= 1.031; 95% IC 1.008 – 1.055; p=0.009) levels were associated with a greater risk of Concentric Hypertrophy .
Using the Kaplan-Meier analysis, it was observed that patients’ survival at 60 months was 90.2 % in patients without Hypertrophy, 76.3 % in patients with Eccentric Hypertrophy and 53.6 % in patients with Concentric Hypertrophy (log rank=9.422; p = 0.009).

Conclusion

In conclusion, both Klotho and FGF23 serum levels represent good biomarkers of CVD in CKD patients they might be used along with imaging techniques, as diagnostic parameters biomarkers of the CVD.