Kidney Week

Abstract: TH-PO1068

High Burden of Premature Ventricular Complexes Predicts Kidney Function Decline in CKD

Session Information

• CKD: Epidemiology, Risk Factors, and Other Conditions
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Yu, Chih-Hen, National Cheng Kung University College of Medicine, Tainan City, Taiwan

Chih-Hen Yu, MD, MS

• Wu, Ping-Hsun, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan

Ping-Hsun Wu, MD, MS, PhD

• Shih, Chao Kuei, National Cheng Kung University College of Medicine, Tainan City, Taiwan

Chao Kuei Shih

• Chen, Chao-Yu, National Cheng Kung University College of Medicine, Tainan City, Taiwan

Chao-Yu Chen

• Hwang, Shang-Jyh, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan

Shang-Jyh Hwang, MD

• Kuo, Mei-Chuan, Kaohsiung Medical University, Kaohsiung, Kaohsiung City, Taiwan

Mei-Chuan Kuo, MD

• Sung, Junne-Ming, National Cheng Kung University College of Medicine, Tainan City, Taiwan

Junne-Ming Sung, DrMed, PhD

Background

Cardiac arrhythmias are common in CKD and may accelerate renal function decline via heart–kidney crosstalk. Premature ventricular complexes (PVCs), prevalent in CKD, may worsen renal function by reducing cardiac output and impairing renal perfusion. CKD promotes PVCs through electrolyte imbalance, fibrosis, and uremia, while high PVC burden is linked to ventricular dysfunction. Despite known cardiovascular risks, the impact of PVCs on CKD progression remains underexplored.

Methods

We conducted a multicenter retrospective cohort study of 1,804 CKD 3b–4 patients from Taiwan's pre-ESRD program (2009–2021) who underwent 24-hour Holter monitoring. High PVC burden was defined as >30 PVCs/hour. The primary outcome was a kidney-specific composite of (1) ≥40% decline in eGFR from baseline (2) progression to ESRD, defined as sustained eGFR <10 mL/min/1.73 m² or initiation of maintenance dialysis. The secondary outcome was the kidney-specific composite plus all-cause mortality. Annual eGFR decline was analyzed using linear mixed-effects models.

Results

Mean age was 68.2±11.3 years; baseline eGFR was 34.8±12.1. High PVC burden was associated with increased risk of the primary outcome (HR 1.349; 95%CI 1.094–1.662; p=0.005), consistent in competing risk analysis (HR: 1.269; p=0.026). Annual eGFR decline was greater in high-burden patients (−0.85mL/min/1.73 m²/year; p<0.001).

Conclusion

High PVC burden independently predicts accelerated renal function decline and adverse renal outcomes in advanced CKD. It may guide early renal risk stratification and prompt PVC-targeted intervention.

Table 1. Association of Premature Ventricular Contraction with Renal Outcomes

Table 2. Annual Change in eGFR (mL/min/1.73 m²/year) Based on Linear Mixed-Effects Model

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025xa7anv4k