Kidney Week

Abstract: TH-PO0336

Association Between Tricuspid Regurgitation Velocity and Pulmonary Hypertension with ESKD: Analysis of the Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

• Hypertension and CVD: Clinical - 1
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Tuttle, Marcelle, Tufts Medical Center, Boston, Massachusetts, United States

Marcelle Tuttle, MD

• Tighiouart, Hocine, Tufts Medical Center, Boston, Massachusetts, United States

Hocine Tighiouart, MS

• Oka, Tatsufumi, Osaka Daigaku, Suita, Osaka Prefecture, Japan

Tatsufumi Oka, MD, PhD

• McCallum, Wendy I., Tufts Medical Center, Boston, Massachusetts, United States

Wendy I. McCallum, MD, MS

• Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States

Sankar D. Navaneethan, MD, MS, MPH, FASN

• Kawut, Steven, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Steven Kawut, MD

• Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States

Mark J. Sarnak, MD, MS

Background

Tricuspid regurgitation velocity (TRV) is an echocardiographic marker which can be used as a proxy for pulmonary artery pressures. Higher TRV and pulmonary hypertension are recognized risk factors for mortality in CKD. Studies evaluating the association of these same measures with kidney progression have been inconsistent.

Methods

All CRIC participants with echocardiograms and TRV measurements recorded prior to reaching dialysis were included in the study. The exposures of interest were TRV and PH (defined as a TRV ≥280 cm/s) which were modeled as time-varying covariates. TRV was obtained every three years. Time-dependent Cox proportional hazards models adjusted for baseline age, sex, blood pressure, ejection fraction, comorbidities, eGFR and albuminuria were used to model the association between these variables and end-stage kidney disease (ESKD), defined as the start of dialysis or receipt of a kidney transplant.

Results

2,285 patients were included. At baseline, 243 participants (15.0%) had pulmonary hypertension and subjects had a mean TRV of 245.7 (SD 34.9) cm/s, mean eGFR of 42.1 ml/min/1.73m² and median urine albumin excretion of 40 mg/g. Over a median follow-up duration of 12.6 years, 988 patients developed ESKD. The presence of PH was associated with significantly higher risk of ESKD in multivariable analyses. (Figure). Similarly, higher TRV was associated with increased risk of ESKD.

Conclusion

TRV as both a continuous and categorical variable is associated with an increased risk of ESKD.

Funding

• Private Foundation Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025a14qdvwa