title: Echocardiographic parameters are independently associated with rate of renal function decline and progression to dialysis in patients with chronic kidney disease.
abstract: OBJECTIVE
  Cardiac abnormalities were frequently noted in patients with chronic kidney disease (CKD). This study is designed to assess whether echocardiographic parameters are associated with rate of renal function decline and progression to dialysis in CKD stage 3 to 5 patients.
  
  
  METHODS
  This longitudinal study enrolled 415 patients. The renal end point was defined as commencement of dialysis. The change in renal function was measured by estimated GFR (eGFR) slope.
  
  
  RESULTS
  Progression to dialysis was predicted by wide pulse pressure, low albumin, low hemoglobin, high calcium-phosphorous product, proteinuria, diuretics use, and concentric left ventricular hypertrophy (LVH) (hazard ratio, 2.03; 95% confidence interval [CI], 1.00 to 4.10; P = 0.05). The eGFR slope was negatively associated with total cholesterol, uric acid, proteinuria, diuretics use, and left atrial (LA) diameter (change in slope, -0.50; 95% CI, -0.89 to -0.11; P = 0.01) and positively associated with albumin and left ventricular ejection fraction (LVEF) (change in slope, 0.06; 95% CI, 0.03 to 0.08; P < 0.001).
  
  
  CONCLUSIONS
  Our study in patients of CKD stage 3 to 5 demonstrated that concentric LVH was associated with progression to dialysis, and that increased LA diameter and decreased LVEF were associated with faster renal function decline. Echocardiography may help identify high-risk groups with progressive decline in renal function to dialysis and rapid progression of renal dysfunction in CKD stage 3 to 5 patients.
authors: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Tzyou First Road, Kaohsiung 807, Taiwan.
authors: Szu-Chia
authors: SC
authors: Chen
authors: Ho-Ming
authors: HM
authors: Su
authors: Chi-Chih
authors: CC
authors: Hung
authors: Jer-Ming
authors: JM
authors: Chang
authors: Wan-Chun
authors: WC
authors: Liu
authors: Jer-Chia
authors: JC
authors: Tsai
authors: Ming-Yen
authors: MY
authors: Lin
authors: Shang-Jyh
authors: SJ
authors: Hwang
authors: Hung-Chun
authors: HC
authors: Chen
mesh_terms: D000368:Aged; D002908:Chronic Disease; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006325:Heart Atria / Q000473:pathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007674:Kidney Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016277:Ventricular Function, Left