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Kidney Week

Abstract: TH-PO482

Moderate Impairment in Kidney Function Is Correlated to Changes in Cardiac Function and Structure

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Author

  • Christensson, Anders, Skåne University Hospital, Malmö, Sweden
Background

Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular diseseas and in severe
renal dysfunction changes in the structure and function of the heart is common. Previous reports show that also early renal dysfunction is a risk factor for cardiovascular death, but it is not fully known if the changes in cardiac structure and function already exist in early impairment of renal function. Cystatin C is a stronger predictor
for the risk of cardiovascular morbidity compared with creatinine. This study aims to investigate if there is an early link between kidney disease and cardiac structural and/or functional changes

Methods

We used a population based cohort, Malmö Preventive Project Re-examination-study (MPP-RES). 1792 participants with mean age 67 ± 6 were examined in 2002-2006. Echocardiography with tissue doppler imaging (TDI) is a method that provides a precise measure of left ventricular (LV) wall motion. Cystatin C was measured in plasma and used in the CKD-EPI formula to estimate glomerular filtration rate (eGFR). General linear regression was used for statistical analyses. We included 1504 of the participants with no prior history of heart failure (HF), EF =>40% and eGFR based >15 mL/min/1,73m2. Patients were divided in 8 groups based on e-GFR levels =>90 mL/min/1.73m2; 80-89; 70-79; 60-69; 50-59; 40-49; 30-39 ;and <30. Number of participants in these groups were 167, 221, 376, 322, 238, 121, 51 and 8, respectivley. 29,9% of the participants were women and 70,1% were men.
We studied associations between e-GFR groups and echocardiography parameters.

Results

Significant correlations were found between eGFR groups and Mean é latsept and Mean E/é in the total cohort (p=0,001 and p=0.022, respectively). These correlations remain significant among men but not among women.
We also dichotomized the cohort in those with eGFR <40 and >40 mL/min/1.73m2 and those with eGFR <50 and >50 mL/min/1.73m2 . This demonstrated that the association was found in partcipants with eGFR <40 mL/min/1.73m2 .

Conclusion

Moderate impairment of renal function correlated significantly with functional and structual echocardiographic markers of early diastolic dysfunction.