Associations between eGFR and albuminuria with right ventricular measures: the MESA-Right Ventricle study.
Associations between eGFR and albuminuria with right ventricular measures: the MESA-Right Ventricle study.
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DOI：
10.1093/ckj/sfad096
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发表时间：
2023-09
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
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作者：
Chronic kidney disease (CKD) is associated with an increased risk of pulmonary hypertension, which may lead to right ventricular (RV) pressure overload and RV dysfunction. However, the presence of subclinical changes in RV structure or function in early CKD and the influence of these changes on mortality are not well studied. We hypothesized that early CKD, as indicated by elevated albuminuria or mild reductions in estimated glomerular filtration rate (eGFR), is associated with greater RV dilation and RV mass. We included 4063 participants (age 45–84 years) without baseline clinical cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis. The associations of baseline creatinine–cystatin C-based eGFR and albuminuria with cardiac magnetic resonance–derived RV measures (2000–02) were examined cross-sectionally with linear regression models. Cox regression models were used to examine whether RV parameters modified the associations of eGFR and albuminuria with all-cause mortality. Participants with reductions in eGFR primarily within the 60–89 mL/min/1.73 m2 category had smaller RV end-diastolic and end-systolic volumes and stroke volume (all adjusted P-trends <.001) than those with eGFR ≥90 mL/min/1.73 m2, an association that was predominantly seen in participants with albuminuria below 30 mg/g creatinine. Albuminuria was more strongly associated with death among those with lower RV volumes (P-values for interaction <.03). Among community-dwelling adults, reductions in eGFR primarily within the normal range were associated with smaller RV volumes and the association of albuminuria with worse survival was stronger among those with smaller RV volumes. Further studies are needed to elucidate the underlying mechanistic pathways that link kidney measures and RV morphology.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
2.8
作者：
Chahal, Harjit;Johnson, Craig;Bluemke, David A.
通讯作者：
Bluemke, David A.
影响因子：
13.6
作者：
Inker, Lesley A.;Coresh, Josef;Muntner, Paul
通讯作者：
Muntner, Paul
影响因子：
3.8
作者：
Husain-Syed F;Gröne HJ;Assmus B;Bauer P;Gall H;Seeger W;Ghofrani A;Ronco C;Birk HW
通讯作者：
Birk HW
影响因子：
13.2
作者：
Coresh, J;Astor, BC;Levey, AS
通讯作者：
Levey, AS