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Kidney Week

Abstract: FR-PO364

Longitudinal Changes of Cardiac Structure and Function in Mild to Moderate CKD: Results from the Korean Cohort Study for Outcomes in Patients with CKD (KNOW-CKD)

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ryu, Hyunjin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kang, Minjung, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Abnormal left ventricular (LV) structure and function are associated with increased risk of adverse outcomes among patients with chronic kidney disease (CKD). However, little is unknown regarding the natural longitudinal changes in cardiac structure and function especially in early CKD patients.

Methods

This was a longitudinal study of a subset of participants of the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) who were enrolled from 2011 to 2012. Patients with CKD at stages from G1 to G3b were included if they had serial echocardiograms performed at baseline and again after 4 years. Age, sex, diabetes, CKD stages, hemoglobin, albumin, lipid profile, systolic blood pressure, and baseline LV mass index were included as covariates in the multivariable analysis for risk factors of de novo LV hypertrophy (LVH).

Results

A total of 378 patients (57.7% male) were enrolled. The numbers of patients with diabetes and hypertension were 65 (17.2%) and 360 (95.2%), respectively. During the follow-up period for 4 years, mean (SD) estimated glomerular filtration rate was declined from 64.1±27.1mL/min/1.73m2 to 54.8±30.8 mL/min/1.73m2. Over 4 years, there was no significant change of LV structure and function among overall subjects. Our subjects were divided into two subgroups based on the baseline eGFR; subgroup I (eGFR ≥60 ml/min/1.73m2) and subgroup II (30 < eGFR <60 ml/min/1.73m2). Mean age (SD) was 46.5±11.2 years in subgroup I, and 55.4±10.8 years in subgroup II (P<0.001). In subgroup analysis, the prevalence of LVH for subgroup I was similar between baseline and follow-up (18.5% vs. 19.9%). However, for subgroup II, LVH increased from 26.2% at baseline to 52.3% at 4 years. There was no significant change over time in the prevalence of systolic and diastolic dysfunction according to CKD stage. In multivariable logistic regression analysis, only age was associated with development of de novo LVH (odds ratio 1.602; 95% confidence interval 1.021-1.105, P=0.003).

Conclusion

In conclusion, LV structure and function of mild to moderate CKD patients (eGFR >30ml/min/1.73m2) did not change significantly over 4 years.

Funding

  • Other U.S. Government Support