Kidney Week

Abstract: FR-PO0566

Myocardial Perfusion Abnormalities and Subsequent Kidney Disease Progression in Patients with Kidney Disease

Session Information

• CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Wu, Ping-Hsun, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ping-Hsun Wu, MD, MS, MSc, PhD

• Liu, Yi-Hsueh, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Hsueh Liu

• Lin, Ming-Yen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ming-Yen Lin, PhD

• Lin, Yi-Ting, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Ting Lin, MD, PhD

• Chen, Szu-Chia, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Szu-Chia Chen

• Chiu, Yi-Wen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Wen Chiu, MD

• Hwang, Shang-Jyh, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Shang-Jyh Hwang, MD

• Kuo, Mei-Chuan, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Mei-Chuan Kuo, MD

Background

The cardiorenal syndrome highlights the bidirectional link between cardiac and renal dysfunction. Myocardial Perfusion Abnormalities and Subsequent Kidney Disease Progression in Patients with Kidney Disease. However, whether MPS-derived abnormalities predict subsequent progression of kidney disease remains uncertain.

Methods

We analyzed patients with kidney disease in the Taiwan Kidney Outcome Cohort (TAKO), a retrospective electronic health record cohort from the Kaohsiung Medical University Health Care System, who underwent thallium-201 MPS. The date of the first MPS examination was defined as the index date. Patients receiving kidney replacement therapy or with malignancy at baseline were excluded. The primary outcome was a composite of estimated glomerular filtration rate (eGFR) decline of at least 40% or end-stage kidney disease (ESKD). Cox proportional hazards models were sequentially adjusted for demographics, comorbidities, kidney and metabolic laboratory data, and medications.

Results

Among 2,438 patients, the mean age was 66.4 years, 55.7% were men, and 88.0% had diabetes. Compared with patients with a summed stress score (SSS) of 0–3, those with abnormal perfusion (SSS ≥4) had a higher risk of kidney disease progression (adjusted hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01–1.32). Stress total perfusion deficit >5% was also associated with higher progression risk (adjusted HR, 1.18; 95% CI, 1.03–1.36). Each 10% lower stress left ventricular ejection fraction was independently associated with increased risk of kidney disease progression (adjusted HR, 1.09; 95% CI, 1.04–1.14).

Conclusion

In patients with kidney disease, higher myocardial ischemic burden (SSS and stress TPD) and lower stress-induced LVEF are independent predictors of adverse renal outcomes. These findings suggest that MPS-derived parameters may serve as valuable prognostic markers for identifying patients at high risk of kidney disease progression, potentially enabling earlier targeted cardiorenal interventions.

Acknowledgment

We thank the Kaohsiung Medical University Hospital care system for its support of this study.