EFFECTS OF LEFT VENTRICULAR MASS AND INDEX IN CHRONIC KIDNEY DISEASE & KIDNEY TX

左心室质量和指数对慢性肾病的影响

• 批准号: 7604300
• 负责人: GEMA ARICETA
• 金额: $ 0.05万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-12-01 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7604300
• 关键词: EFFECTS; LEFT; VENTRICULAR; MASS; INDEX

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Elevated plasma B-type natriuretic peptide (BNP) level is a hallmark of altered left ventricular (LV) structure and function. It is used as a diagnostic aid of congestive heart failure and coronary syndrome in adults. In addition, BNP predicts cardiovascular morbidity and mortality in adults on dialysis. Elevated plasma BNP has also been observed in adults with early stages of essential hypertension (HTN) when only blunting of the nocturnal blood pressure (BP) dip was detected. Among them BNP correlated positively with left ventricular mass index (LVMI) and negatively with LV diastolic function (p greater than 0.01), suggesting cardiac end-organ damage was a stronger variable over HTN for determination of plasma BNP level. The goal for this ancillary study is to evaluate the relationship between LVMI and BNP in children, adolescents and young adults with chronic kidney disease (CKD) and renal transplant recipients (RTR), with comparison to age-gender-and-BMI-matched hypertensives with normal renal function but LVH, since these three cohorts share identical mechanisms in the development of CVD, despite normal kidney function in the hypertensives. For our 18-month ancillary study, we will consent and enroll three age-gender-ethnicity-and body mass index (BMI)-matched cohorts of subjects: hypertensives with known left ventricular hypertrophy (LVH), normal renal function and LDL less than 92 mg/dL, CKD stage II-III (K/DOQI) and RTR patients with LDL greater than 92 mg/dL. CKD and RTR subjects will be from a larger treatment study (IRB-approved study #2003-12079, GCRC #854). As part of it, CKD and RTR will receive either standard care or standard care with statin therapy to lower LDL, based upon recent recommendations. We will draw additional blood at the same time it will be drawn for the larger study, and have the subjects collected a first morning voided urine specimen. We will measure plasma BNP, hemoglobin, hematocrit, serum creatinine (SCr), urine microalbumin, total body water (TBW) by bioimpedance, LVMI by ultrasound and 24h ambulatory BP monitoring in our study population. In the CKD and RTR subjects, we will record data that will be collected for the larger study (LVM, LVMI, SCr, 24-hour ambulatory BP, urine isoprostanes; plasma ADMA/arginine; bilateral common carotid artery IMT, compliance, and distensibility; endothelial dependent dilatation (EDD); TNF-alpha; and C-reactive protein.

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