Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease: findings from the CKD-JAC study

Nitta, Kosaku; Iimuro, Satoshi; Imai, Enyu; Matsuo, Seiichi; Makino, Hírofumi; Akizawa, Tadao; Watanabe, Tsuyoshi; Ohashi, Yasuo; Hishida, Akira

doi:10.1007/s10157-018-1605-z

Cited by 23 publications

(15 citation statements)

References 42 publications

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“…The CKD-JAC study (University Hospital Medical Information Network (UMIN) clinical trial number: UMIN000020038) was a prospective cohort study to determine the incidence rates of ESKD (32) and cardiovascular disease (33) and to identify their risk factors (34,35) during the 4-year follow-up period in Japanese patients with CKD. The study protocol has been described in detail elsewhere (36).…”

Section: Participantsmentioning

confidence: 99%

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Yamamoto

Shinzawa

Isaka

et al. 2018

CJASN

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Background and objectives Shorter or longer sleep duration and poor sleep quality are risk factors for numerous cardio-metabolic diseases, cardiovascular disease, and mortality in subjects with normal kidney function. The association of sleep duration and sleep quality with health outcomes in patients with CKD remains uncertain.Design, setting, participants, & measurements A 4-year prospective cohort study in 17 nephrology centers in Japan, the CKD Japan Cohort (CKD-JAC) Study, assessed an association of self-reported sleep duration and sleep quality, on the basis of the Pittsburgh Sleep Quality Index (PSQI) questionnaire, with incidence of ESKD in 1601 patients with eGFR 10-59 ml/min per 1.73 m 2 using multivariable-adjusted Cox proportional hazards models.Results Baseline sleep duration and PSQI global score for the 1601 patients were mean6SD 7.061.3 hours and median 4 (interquartile range, 3-7), respectively. Poor sleep quality (PSQI global score $6) was common (n=588 [37%]). During a median of 4.0 (2.6-4.3) years of the follow-up period, 282 (18%) patients progressed to ESKD. After adjusting for age, sex, eGFR, urinary albumin excretion, smoking status, body mass index, history of diabetes and cardiovascular disease, systolic BP, blockade of the renin-angiotensin system, use of hypnotics, and Beck depression inventory score, both shorter (#5 hour) and longer (.8 hour) sleep duration were associated with ESKD (adjusted hazard ratios [95% confidence intervals] for #5.0, 5.1-6.0, 6.1-7.0, 7.1-8.0, and $8.0 hours were 2.05 [1.31 to3.21], 0.98 [0.67 to 1.44], 1.00 [reference], 1.22 [0.89 to 1.66], and 1.48 [1.01 to 2.16]), suggesting a U-shaped relationship between sleep duration and ESKD. PSQI global score $6 was also associated with incidence of ESKD (adjusted hazard ratios [95% confidence intervals] for PSQI global score #5 and $6 were 1.00 [reference] and 1.33 [1.03 to 1.71]).Conclusions Shorter (#5 hour) and longer (.8 hour) sleep duration and poor sleep quality (PSQI global score $6) were associated with ESKD in patients with CKD.

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Section: Participantsmentioning

confidence: 99%

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Yamamoto

Shinzawa

Isaka

et al. 2018

CJASN

Self Cite

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“…Diagnosis and correction of anemia are important as chronic anemia predisposes them to high morbidity and mortality, mostly secondary to cardiovascular diseases [14]. The risk of left ventricular hypertrophy (LVH) and congestive heart failure (CHF) increases with anemia in CKD patients [15]. Unexplained anemia was the most common indication of BM in a study done by Weng et al to assess the importance of BM pathology as a predictor of mortality in CKD patients on hemodialysis [16].…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Findings in Renal Patients: A Single Renal Specialist Center Experience

Nasir¹,

Qureshi²,

Qureshi³

et al. 2021

Cureus

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This study evaluated the importance of bone marrow aspiration and trephine biopsy (BM) for the diagnosis of underlying hematological abnormalities in renal patients. MethodsThis cross-sectional study on BM was carried out between August 2010 and April 2019, in our specialist renal center for various unexplained hematological abnormalities in patients with renal diseases [chronic kidney disease (CKD), end-stage renal disease (ESRD) requiring maintenance hemodialysis (MHD), patients with normal renal function but other nephrology and urology issues like stone disease and nephrotic syndrome]. ResultsOut of 176 reported BM examinations, 48 (27.3%) were done on ESRD patients on MHD (CKD-D), and 69 (39.2%) on CKD patients not on MHD (CKD-nD). Fifty-nine (33.5%) BM were done on patients with normal renal function (n-CKD). The indication for BM was pancytopenia 50 (28.4%), unexplained anemia 39 (22.2%), and unexplained thrombocytopenia 43 (24.4%). In 91 (51.7%) patients BM was normal. In 30 (17%) patients multiple myeloma (MM) was diagnosed on BM, out of which 18 (26.1%), nine (18%), three (5.3%) were CKD-nD, CKD-D, and n-CKD patients, respectively. In 11 (6.3%) patients BM was suggestive of myelodysplasia (MD), out of these 11 patients, five (10%) were CKD-D patients. ConclusionBM is an underutilized method of diagnosis of hematological abnormalities in renal patients. Our study revealed the importance of BM examination, especially in patients with CKD.

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“…Although blood pressure still plays a major role in inducing LV remodelling in CKD, some other CKD-related factors are also known to be involved in this process. Some studies have proposed the independent risk factors for LVH in patients with CKD5-ND 7 , patients undergoing haemodialysis 21 , and patients undergoing peritoneal dialysis 12 . Chronic inflammation, anaemia, hypoalbuminaemia, hyperphosphataemia, arterial hypertension, and/or arterial stiffness, and high serum fibroblast growth factor 23 (FGF-23) levels were suggested as contributing factors for LVH in patients with CKD not undergoing dialysis 22 – 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Structural and functional cardiac changes, such as left ventricular hypertrophy (LVH) and left ventricular (LV) diastolic dysfunction, can be seen in patients with even mild-to-moderate chronic kidney disease (CKD) regardless of the cause. Patients with CKD have a high prevalence of LVH, ranging from 29 to 74% in different studies, and its prevalence increases as kidney function decreases 1 – 7 .…”

Section: Introductionmentioning

confidence: 99%

Relative overhydration is independently associated with left ventricular hypertrophy in dialysis naïve patients with stage 5 chronic kidney disease

Han

Lee

Choi

et al. 2020

Sci Rep

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Patients with chronic kidney disease (CKD) have a high prevalence of left ventricular hypertrophy (LVH), which increases as kidney function decreases. LVH pathophysiology is complex, making it difficult to generalise its evolution in CKD. Therefore, early detection and prevention of risk factors are critical. Assessment and management of volume status can minimise cardiovascular complications including LVH. We retrospectively investigated the associations between fluid overload and LVH in patients with stage 5 CKD not undergoing dialysis in prospective cohort of 205 patients (age: 59.34 ± 13.51 years; women: 43.4%). All patients, free of intrinsic heart disease, were assessed for relative overhydration/extracellular water (OH/ECW) by bioimpedance spectroscopy. Our results show that markers reflecting fluid balance were significantly higher in the LVH group and as OH/ECW increased, the left ventricular mass index (LVMI) trended higher. Furthermore, our results show that systolic blood pressure, serum phosphorus levels, and OH/ECW were independently associated with LVMI and that OH/ECW was independently associated with LVH. Structural and functional evaluation of the heart using echocardiography and volume status assessment using bioimpedance should be performed simultaneously in patients with early-stage CKD, even in those without evident cardiovascular disease.

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Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease: findings from the CKD-JAC study

Abstract: The cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.

Cited by 23 publications

References 42 publications

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Sleep Quality and Sleep Duration with CKD are Associated with Progression to ESKD

Bone Marrow Findings in Renal Patients: A Single Renal Specialist Center Experience

Relative overhydration is independently associated with left ventricular hypertrophy in dialysis naïve patients with stage 5 chronic kidney disease

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