Details

Autor(en) / Beteiligte

• Moran, Andrew, MD, MPH
• Katz, Ronit, DPhil
• Jenny, Nancy Swords, PhD
• Astor, Brad, PhD, MPH
• Bluemke, David A., MD, PhD
• Lima, João A.C., MD
• Siscovick, David, MD, MPH
• Bertoni, Alain G., MD
• Shlipak, Michael G., MD, MPH

Titel

Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C: The Multi-Ethnic Study of Atherosclerosis (MESA)

Ist Teil von

• American journal of kidney diseases, 2008-11, Vol.52 (5), p.839-848

Ort / Verlag

Orlando, FL: Elsevier Inc

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Left ventricular (LV) hypertrophy (LVH) is associated with chronic kidney disease, but the association of LVH with a mild decrease in kidney function is not known. We hypothesized that mild and moderate decreases in kidney function, reflected in greater serum cystatin C concentrations, would be linearly associated with a greater prevalence of LVH. Study Design Cross-sectional observational study. Settings & Participants Participants in baseline examinations in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based study with several sites in the United States. Predictors Cystatin C–based estimated glomerular filtration rate (eGFRcysC ) and creatinine-based eGFR. Outcomes LVH and LV mass index. Measurements Serum cystatin C and creatinine, LV mass obtained by using magnetic resonance imaging. LVH cutoff values for men and women were defined by the upper 95th percentile of LV mass index of all MESA participants without hypertension. Results Of the 4,971 participants analyzed, mean creatinine-based eGFR was 81 ± 17 (SD) mL/min/1.73 m2 and mean eGFRcysC was 94 ± 32 mL/min/1.73 m2 . LVH was distinctly more prevalent (>12%) in only the lowest 2 deciles of eGFRcysC (<75 mL/min/1.73 m2 ). When 435 participants (9%) with stage 3 or higher chronic kidney disease (creatinine-based eGFR < 60 mL/min/1.73 m2 ) were excluded, the odds for LVH increased for each lower category of eGFRcysC less than 75 mL/min/1.73 m2 : odds ratio 1.6 for LVH with eGFRcysC of 60 to 75 mL/min/1.73 m2 (95% confidence interval, 1.20 to 2.07; P = 0.001), and odds ratio 2.0 for eGFRcysC less than 60 mL/min/1.73 m2 (95% confidence interval, 1.03 to 3.75; P = 0.04) after adjustment for demographic factors, study site, diabetes, and smoking. The association of lower eGFRcysC with LVH was attenuated after further adjustment for hypertension. Limitations Cross-sectional rather than longitudinal design, lack of participants with more advanced kidney disease, lack of a direct measurement of glomerular filtration rate. Conclusions In participants without chronic kidney disease, eGFRcysC of 75 mL/min/1.73 m2 or less was associated with a greater odds of LVH.