TY - JOUR
T1 - Echocardiographic measures and subsequent decline in kidney function in older adults
T2 - the Atherosclerosis Risk in Communities Study
AU - Ishigami, Junichi
AU - Mathews, Lena
AU - Hishida, Manabu
AU - Kitzman, Dalane W.
AU - Coresh, Josef
AU - Solomon, Scott D.
AU - Shah, Amil M.
AU - Matsushita, Kunihiro
N1 - Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201 700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201 700004I).
Publisher Copyright:
© The Author(s) 2021.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Aims Heart failure increases the risk of kidney disease progression. However, whether cardiac function and structure are associated with the risk of incident chronic kidney disease (CKD) is not well characterized in a community setting. Methods Among 4188 participants (mean age 75 years and 22% blacks) of the Atherosclerosis Risk in Communities Study and results without prevalent CKD in 2011–13, we examined the association of echocardiographic measures of left ventricular (LV) mass index, ejection fraction, left atrial volume index (LAVi), right ventricular (RV) fractional area change, and peak RV-right atrium (RA) gradient, with the subsequent risk of incident CKD, as defined by >25% decline to estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, hospitalization with CKD diagnosis, or incident end-stage kidney disease. Multivariable Cox regression models were used to estimate hazard ratios (HRs). The risk of incident CKD was monotonically increased with each of higher LV mass index [adjusted HR 2.61 (1.92–3.55) for highest quartile (Q4) vs. lowest (Q1)], lower ejection fraction [1.54 (1.17–2.04) for Q1 vs. Q4], higher LAVi [2.12 (1.56–2.89) for Q4 vs. Q1], and higher peak RV-RA gradient [2.17 (1.45–3.25) for Q4 vs. Q1] but not with RV function. The associations were consistent between subgroups by sex and race. Conclusion Among community-dwelling older individuals, LV mass index, ejection fraction, LAVi, and peak RV-RA gradient were independently associated with the risk of incident CKD. Our results further support that heart disease is associated with the risk of kidney disease progression and suggest the value of echocardiography for assessing cardiac and kidne health in older o ulations.
AB - Aims Heart failure increases the risk of kidney disease progression. However, whether cardiac function and structure are associated with the risk of incident chronic kidney disease (CKD) is not well characterized in a community setting. Methods Among 4188 participants (mean age 75 years and 22% blacks) of the Atherosclerosis Risk in Communities Study and results without prevalent CKD in 2011–13, we examined the association of echocardiographic measures of left ventricular (LV) mass index, ejection fraction, left atrial volume index (LAVi), right ventricular (RV) fractional area change, and peak RV-right atrium (RA) gradient, with the subsequent risk of incident CKD, as defined by >25% decline to estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, hospitalization with CKD diagnosis, or incident end-stage kidney disease. Multivariable Cox regression models were used to estimate hazard ratios (HRs). The risk of incident CKD was monotonically increased with each of higher LV mass index [adjusted HR 2.61 (1.92–3.55) for highest quartile (Q4) vs. lowest (Q1)], lower ejection fraction [1.54 (1.17–2.04) for Q1 vs. Q4], higher LAVi [2.12 (1.56–2.89) for Q4 vs. Q1], and higher peak RV-RA gradient [2.17 (1.45–3.25) for Q4 vs. Q1] but not with RV function. The associations were consistent between subgroups by sex and race. Conclusion Among community-dwelling older individuals, LV mass index, ejection fraction, LAVi, and peak RV-RA gradient were independently associated with the risk of incident CKD. Our results further support that heart disease is associated with the risk of kidney disease progression and suggest the value of echocardiography for assessing cardiac and kidne health in older o ulations.
KW - chronic kidney disease
KW - diastolic dysfunction
KW - echocardiography
KW - ejection fraction
KW - heart failure
KW - left ventricular mass index
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U2 - 10.1093/ehjci/jeaa418
DO - 10.1093/ehjci/jeaa418
M3 - Article
C2 - 33517414
AN - SCOPUS:85123876821
SN - 2047-2404
VL - 23
SP - 283
EP - 293
JO - European heart journal cardiovascular Imaging
JF - European heart journal cardiovascular Imaging
IS - 2
ER -