Left ventricular myocardial mass index associated with cardiovascular and renal prognosis in IgA nephropathy

Sági, Balázs; Késői, István; Vas, Tibor; Csiky, Botond; Nagy, Judit; Kovács, Tibor József

doi:10.1186/s12882-022-02909-1

Cited by 7 publications

(5 citation statements)

References 52 publications

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“…This phenomenon may be unique to all chronic glomerular diseases where patients have hypertension-induced LVH and deteriorating renal function, and they also have metabolic syndrome. Our previous data confirmed that these two cardiometabolic alterations cause higher cardiovascular morbidity and mortality [36,37]. So, it is indispensable to recognize the high CV risk of IgAN patients and treat them more aggressively to reduce their risk.…”

Section: Discussionsupporting

confidence: 68%

“…In our study, the K-M curve revealed that PLTs, the PLR, and the PAR were all significantly linked with the renal but not the cardiovascular outcomes of IgAN, indicating that each of them may be used as prospective predictors of renal endpoints, as Tan et al [12] reported in their cohort. In our previous studies, we found that the left ventricular mass index (LVMI) and the development of metabolic syndrome (MetS) in IgAN patients have an impact on cardiovascular outcomes [36,37]. Inflammatory parameters may indicate further factors that are responsible for the accelerated manifestation of the endpoints.…”

Section: Discussionmentioning

confidence: 99%

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Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy?

Sági,

Vas,

Csiky

et al. 2024

JCM

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Background: IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as the platelet (PLT) count, platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. We were interested in whether platelet-related parameters are risk factors for ESKD and CV events in IgAN patients. Methods: In a monocentric retrospective study, 124 IgAN patients were divided into two groups based on the cut-off value of the PAR. All-cause mortality, major CV events, and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results: The patients’ mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that the PLR, PAR, and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS), the PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, the PLR correlated with albuminuria (r = −0.165, p = 0.033) and LVH (r = −0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusions. Elevated PARs and PLRs may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they were related to CV events in IgAN. The determination of PARs and PLRs can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in IgAN.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy?

Sági,

Vas,

Csiky

et al. 2024

JCM

Self Cite

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“…An independent predictor of ESKD and CV events may be a higher LVMI. Increased LVMI should draw attention to CKD patients who require closer monitoring, referral for additional CV testing, and maximal renal and heart protection since they have a higher risk of cardiovascular and renal disease at an early stage of the disease (II-IV) [81]. In our current study, there was no significant difference in LVMI between the MetS and non-MetS groups.…”

Section: Discussioncontrasting

confidence: 44%

Does the Metabolic Syndrome and Its Components Have Prognostic Significance for Renal and Cardiovascular Outcomes in IgA Nephropathy?

Sági,

Vas,

Csiky

et al. 2024

Preprint

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Background: Cardiovascular (CV) morbidity and mortality are many times higher in chronic kidney disease (CKD), as well as IgA nephropathy (IgAN), than in the general population. The occurrence of metabolic syndrome (MetS) and metabolic risk factors are independent risk factors for CV disease and renal progression. The study aimed to determine the prognostic role of metabolic profiles in a homogenous group of CKD patients. Methods: One hundred and forty-five IgA nephropathy patients (92 male, 53 female, age 54.7 ± 13 years) with CKD stage 1-4 were investigated and followed for a median of 190 months. The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularization (CV), end-stage renal disease, and renal replacement therapy (renal). Results: Patients with MetS had significantly more endpoint events (16/27 patients vs. 15/98 patients, p = 0.001) compared to the nonMetS group. Of the secondary endpoints (CV or renal separately), the rate of the renal and CV endpoints was significantly higher in the MetS group (p = 0.001 and p = 0.029). The primary endpoint independent predictors of survival were dyslipidemia, eGFR, hemoglobin, urine albuminuria, and diabetes mellitus, as determined by Cox regression analysis. Independent predictors of secondary renal endpoint were dyslipidemia, hemoglobin, urine albumin, and eGFR. Predictors of secondary cardiovascular endpoints were gender, BMI, and diabetes. Kaplan-Meier curves showed significant differences in MetS and non-MetS when examined at the combined endpoints (CV and renal) or at each endpoint separately. The primary endpoint rate increased significantly with the increased number of MetS components (MetS comp. 0 vs. MetS comp. 2+, primary endpoints, p = 0.012). Conclusion: Our results showed that the metabolic profile has a prognostic role not only for renal endpoints but also for CV endpoints in IgAN. BMI, hyperuricemia, hypertension, and diabetes have a predictive value for the prognosis of IgA nephropathy.

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“…Similarly, LVMI assessed via echocardiography represented a potential prognostic factor in patients with IgA nephropathy, underling a correlation between high LVMI values, renal replacement therapy, and cardiovascular events [27].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease

Lacquaniti,

Ceresa,

Campo

et al. 2024

Medicina

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Background and Objectives: Several studies revealed a relation between abnormal cardiac remodeling and glomerular filtration rate (GFR) decline, but there are limited data regarding echocardiographic changes in chronic kidney disease (CKD). This study evaluated the abnormal cardiac structures characterizing patients with CKD, assessing the independent association between echocardiographic parameters and the risk of decline in renal function. Materials and Methods: In total, 160 patients with CKD were studied. All patients underwent an echocardiographic exam and 99mTc-DTPA renal scintigraphy to measure the GFR. After the baseline assessments, patients were followed prospectively for 12 months, or until the endpoint achievement, defined as a worsening in renal function (doubling of baseline serum creatinine, GFR decline ≥25%, the start of dialysis). Results: Patients with GFR values of 34.8 ± 15 mL/min, identifying stages III–IV of CKD, were associated with high levels of left ventricular mass index (LVMi) (101.9 ± 12.2 g/m2), which was related to proteinuria, systolic blood pressure, and pulmonary artery systolic pressure in a multiple regression model. During the observational period, 26% of patients reached the endpoint. Regression analysis revealed LVMi as a predictor of change in renal function after adjusting for kidney and cardiac risk factors. Multiple Cox regression indicated that an increase in LVMi was associated with a 12% increased risk of kidney disease progression (HR: 1.12; 95% CI: 1.04–1.16; p = 0.001). Conclusions: In patients with CKD, high LVMi represents an independent predictor of the progressive decline of the renal function, until the start of renal replacement therapy. Echocardiography can help identify patients at high risk for renal disease worsening in patients with CKD independently of clinical cardiac involvement.

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Left ventricular myocardial mass index associated with cardiovascular and renal prognosis in IgA nephropathy

Cited by 7 publications

References 52 publications

Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy?

Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy?

Does the Metabolic Syndrome and Its Components Have Prognostic Significance for Renal and Cardiovascular Outcomes in IgA Nephropathy?

Left Ventricular Mass Index Predicts Renal Function Decline in Patients with Chronic Kidney Disease

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