Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW-CKD Dataopen access
- Authors
- Kang, Eunjeong; Lee, Sung Woo; Ryu, Hyunjin; Kang, Minjung; Kim, Seonmi; Park, Sue K.; Jung, Ji Yong; Lee, Kyu-Beck; Han, Seung Hyeok; Ahn, Curie; Oh, Kook-Hwan
- Issue Date
- Jul-2022
- Publisher
- WILEY
- Keywords
- cardiorenal syndrome; chronic kidney disease; diastolic heart dysfunction; early predictor; progression
- Citation
- JOURNAL OF THE AMERICAN HEART ASSOCIATION, v.11, no.13
- Journal Title
- JOURNAL OF THE AMERICAN HEART ASSOCIATION
- Volume
- 11
- Number
- 13
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/85104
- DOI
- 10.1161/JAHA.122.025554
- ISSN
- 2047-9980
- Abstract
- Background Few studies have examined the association between the early diastolic mitral inflow velocity/early diastolic mitral annulus velocity ratio (E/e') and chronic kidney disease progression. Methods and Results We reviewed data from 2238 patients with nondialysis chronic kidney disease from the KNOW-CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease); data from 163 patients were excluded because of missing content. A >50% decrease in estimated glomerular filtration rate from baseline, doubling of serum creatinine, or dialysis initiation and/or kidney transplantation were considered renal events. At baseline, median (interquartile range) ejection fraction and E/e' were 64.0% (60.0%-68.0%) and 9.1 (7.4-11.9), respectively. Proportions of ejection fraction <50% and E/e' >= 15 were 1.3% and 9.6%, respectively. More than one quarter of patients (27.2%) had an estimated glomerular filtration rate <30 mL/min per 1.73 m(2). During the mean 59.1-month follow-up period, 724 patients (34.9%) experienced renal events. In multivariable Cox proportional hazard regression analysis, the hazard ratio with 95% CI per 1-unit increase in E/e' was 1.027 (1.005-1.050; P=0.016). Penalized spline curve analysis yielded a suggested threshold of E/e' for renal events of 12; in our data set, the proportion of E/e' >= 12 was 4.1%. Conclusions Increased E/e' was associated with an increased hazard of renal events, suggesting that diastolic heart dysfunction is a novel risk factor for chronic kidney disease progression.
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