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Abstract: PO2073

Cardiac Structure and Function and Long-Term Risk of ESKD in African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Hishida, Manabu, Johns Hopkins University, Baltimore, Maryland, United States
  • Ishigami, Junichi, Johns Hopkins University, Baltimore, Maryland, United States
  • Mathews, Lena, Johns Hopkins University, Baltimore, Maryland, United States
  • Grams, Morgan, Johns Hopkins University, Baltimore, Maryland, United States
  • Coresh, Josef, Johns Hopkins University, Baltimore, Maryland, United States
  • Solomon, Scott D., Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Matsushita, Kunihiro, Johns Hopkins University, Baltimore, Maryland, United States

Group or Team Name

  • Welch Center
Background

Cardiovascular disease and end-stage kidney disease (ESKD) disproportionally affect African Americans. Whether cardiac structure and function is associated with the risk of ESKD in this population is not well-characterized.

Methods

In 1,929 African American ARIC participants who underwent echocardiography between 1993-1995 (mean age 58.5 [SD 5.6] years, 36% male), we explored the association of left ventricular mass index (LVMI), fraction shortening (FS), left atrial diameter (LAD), and LV end-diastolic diameter (LVEDD) with the subsequent risk of ESKD using Kaplan-Meier method and multivariable Cox models.

Results

During a median follow-up of 22.3 years, 82 participants developed ESKD (incidence rate, 3.0 per 1,000 person-years). The cumulative incidence of ESKD was highest in the top quartile (bottom quartile for FS) of all echo parameters (Figure), although the risk separation was most evident for LVMI. The association of LVMI with ESKD remained significant even after accounting for potential confounders like blood pressure and clinical history of cardiovascular disease (HR, 2.46 [1.13-5.38] in the top vs. bottom quartile). FS, LAD, or LVEDD were not independently associated with ESKD.

Conclusion

Among African Americans, higher LVMI was robustly and independently associated with the risk of ESKD. Our findings support the importance of LVMI or its pathophysiology in CKD progression in African Americans.