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- W2128233866 abstract "Background. The role of cardiovascular factors in predicting renal outcome has not been extensively elucidated. Herein, we report a prospective evaluation of the impact of left ventricular hypertrophy (LVH) on outcome in non-diabetic patients with chronic kidney disease (CKD). Methods. We studied 144 patients (99 men; age 62 ± 14 years) with stage 3–4 CKD, with baseline assessment of left ventricular mass index (LVMi) by echocardiography, estimated glomerular filtration rate (eGFR) by MDRD equation, 24-h blood pressure profile and 24-h proteinuria. Combined end point was progression to ESRD requiring dialysis, or death within 5 years. Results. Forty-nine patients (34%) progressed to dialysis, 24 (17%) died, 57 (39%) were dialysis-free after 5 years and 14 were lost to follow-up. Multivariate Cox proportional hazards analysis showed that increased LVMi (HR 1.28, 95% CI 1.17–1.40 for each 10-g/m2 increase, P < 0.0001) and reduced eGFR (5% risk increase for each 1-mL/min reduction, P = 0.027) were the significant predictors of the combined end point in stage 3 CKD patients, whereas LVMi proved to be the only significant predictor of the combined end point in patients with stage 4 CKD (HR 1.19, 95% CI 1.09–1.31, P < 0.0001). The same analysis showed that LVMi was the only significant predictor of progression to dialysis in stage 3 CKD patients (HR 1.42, 95% CI 1.23–1.64 for each 10-g/m2 increase, P < 0.0001), while a 20% increase in the risk of progression to ESRD was observed for each 10-g/m2 increase in LVMi (P < 0.0001), and a 10% increase for each 1-mL/min reduction in eGFR (P = 0.046) in patients with stage 4 CKD. When evaluating the predictive role of LVMi on outcome using AUC-ROC curves, the overall performance of the model including LVMi (AUC 0.877, 95% CI 0.8–0.954) was superior to the model including eGFR (AUC 0.737, 95% CI 0.656–0.817) for the end point of progression to dialysis (P = 0.026, Hanley test). Conclusions. LVH proved to be the strongest predictor of the risk of progression to dialysis in non-diabetic CKD, especially among patients with less advanced renal dysfunction. Regardless of whether it is a simple marker or a pathogenetic factor, LVH encompasses all factors possibly affecting renal and general outcome in CKD patients." @default.
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- W2128233866 date "2010-07-13" @default.
- W2128233866 modified "2023-10-16" @default.
- W2128233866 title "Is left ventricular hypertrophy a powerful predictor of progression to dialysis in chronic kidney disease?" @default.
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- W2128233866 doi "https://doi.org/10.1093/ndt/gfq409" @default.
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