The effect of anemia and left ventricular geometric patterns on renal disease progression in type 2 diabetic nephropathy.

Abstract:

BACKGROUND:Left ventricular (LV) geometric patterns have never been evaluated as independent risk factors for renal disease progression (RDP). We investigated the risk factors for RDP in type 2 diabetic nephropathy patients, especially focusing on the effects of LV geometric patterns. METHODS:This was a single-center retrospective cohort study. Type 2 diabetic nephropathy patients who underwent echocardiography for routine checkup were recruited. Baseline laboratory data within 1 month from the time of echocardiography and clinical and follow-up laboratory data were collected by retrospective reviews. RESULTS:A total of 150 patients (90 men, mean age 62.9 years) were enrolled. Distributions of the patients according to LV geometric patterns were as follows: normal 21 (14.0%), concentric remodeling 18 (12.0%), concentric hypertrophy 70 (46.7%) and eccentric hypertrophy 41 (27.3%). During the study period (30.1 ± 19.4 months), RDP developed in 53 of 150 patients (35.3%). On univariate analysis, use of erythropoiesis-stimulating agent, hemoglobin, serum creatinine, estimated glomerular filtration rate (eGFR), serum albumin, log-transformed 24-hour urine protein, LV mass index and eccentric hypertrophy were strong predictors of renal outcomes. RDP-free survival was significantly decreased in the eccentric hypertrophy group (p=0.001, vs. other groups) according to Kaplan-Meier analysis. On multivariate analysis, eGFR, eccentric hypertrophy and hemoglobin levels were significant predictors of renal outcome. CONCLUSION:Anemia and eccentric hypertrophy may be considered as important risk factors for RDP. Multicenter prospective trials should be needed to validate the effect of LV geometric patterns on RDP.

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Moon SJ,Bae KS,Park HC,Kim JK,Park JT,Lee JE,Rim SJ,Ha SK

doi

10.5301/jn.2010.353

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

50-9

issue

1

eissn

1121-8428

issn

1724-6059

pii

653BA257-FF3D-40D1-B4E5-8F709B99FF5C

journal_volume

24

pub_type

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