Association of echocardiographic abnormalities with mortality in men with non-dialysis-dependent chronic kidney disease

Jason Payne, Smriti Sharma, Dexter De Leon, Jun L. Lu, Fregenet Alemu, Rasheed A. Balogun, Sandra M. Malakauskas, Kamyar Kalantar-Zadeh, Csaba Kovesdy

Research output: Contribution to journalArticle

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Abstract

Background. The interrelationship of left ventricular hypertrophy (LVH) with ejection fraction (EF) and their impact on mortality in non-dialysis-dependent chronic kidney disease (NDD-CKD) is unclear. Methods. We examined the associations of EF and LVH with all-cause mortality in a historic cohort of 650 male US veterans with moderate-to-advanced NDD-CKD. EF and LVH were examined both separately and after categorizing patients according to their concomitant EF and presence/absence of LVH. Associations with mortality were examined in Cox models with adjustments for demographics, blood pressure, comorbidities, smoking status, medication use and biochemical characteristics. Results. EF <30 and 30-50% were associated with higher all-cause mortality compared to EF >50% even after multivariable adjustments [multivariable adjusted hazard ratio, 95% confidence interval (CI): 2.83 (1.86-4.30) and 1.38 (1.06-1.78), P < 0.001 for linear trend]. LVH in itself was not associated with mortality [multivariable adjusted hazard ratio, 95% CI: 0.83 (0.66-1.05), P = 0.12], but the presence of LVH combined with an EF <50% was associated with the highest mortality [multivariable adjusted hazard ratios, 95% CI in patients with EF >50% + LVH, EF ≤50%-LVH and EF ≤50% + LVH, compared to EF >50%-LVH: 0.84 (0.63-1.13), 1.36 (1.00-1.83) and 1.62 (1.07-2.46)].Conclusions.Low EF is associated with higher mortality in patients with NDD-CKD. In the presence of a low EF, LVH is also associated with higher mortality. Clinical trials are needed to determine if interventions targeting patients with low EF and LVH can lower mortality in NDD-CKD.

Original languageEnglish (US)
Pages (from-to)694-700
Number of pages7
JournalNephrology Dialysis Transplantation
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2012

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Left Ventricular Hypertrophy
Chronic Renal Insufficiency
Mortality
Stroke Volume
Social Adjustment
Veterans
Proportional Hazards Models
Comorbidity
Smoking
Demography
Clinical Trials
Confidence Intervals
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

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Association of echocardiographic abnormalities with mortality in men with non-dialysis-dependent chronic kidney disease. / Payne, Jason; Sharma, Smriti; De Leon, Dexter; Lu, Jun L.; Alemu, Fregenet; Balogun, Rasheed A.; Malakauskas, Sandra M.; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba.

In: Nephrology Dialysis Transplantation, Vol. 27, No. 2, 01.02.2012, p. 694-700.

Research output: Contribution to journalArticle

Payne, J, Sharma, S, De Leon, D, Lu, JL, Alemu, F, Balogun, RA, Malakauskas, SM, Kalantar-Zadeh, K & Kovesdy, C 2012, 'Association of echocardiographic abnormalities with mortality in men with non-dialysis-dependent chronic kidney disease', Nephrology Dialysis Transplantation, vol. 27, no. 2, pp. 694-700. https://doi.org/10.1093/ndt/gfr282
Payne, Jason ; Sharma, Smriti ; De Leon, Dexter ; Lu, Jun L. ; Alemu, Fregenet ; Balogun, Rasheed A. ; Malakauskas, Sandra M. ; Kalantar-Zadeh, Kamyar ; Kovesdy, Csaba. / Association of echocardiographic abnormalities with mortality in men with non-dialysis-dependent chronic kidney disease. In: Nephrology Dialysis Transplantation. 2012 ; Vol. 27, No. 2. pp. 694-700.
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abstract = "Background. The interrelationship of left ventricular hypertrophy (LVH) with ejection fraction (EF) and their impact on mortality in non-dialysis-dependent chronic kidney disease (NDD-CKD) is unclear. Methods. We examined the associations of EF and LVH with all-cause mortality in a historic cohort of 650 male US veterans with moderate-to-advanced NDD-CKD. EF and LVH were examined both separately and after categorizing patients according to their concomitant EF and presence/absence of LVH. Associations with mortality were examined in Cox models with adjustments for demographics, blood pressure, comorbidities, smoking status, medication use and biochemical characteristics. Results. EF <30 and 30-50{\%} were associated with higher all-cause mortality compared to EF >50{\%} even after multivariable adjustments [multivariable adjusted hazard ratio, 95{\%} confidence interval (CI): 2.83 (1.86-4.30) and 1.38 (1.06-1.78), P < 0.001 for linear trend]. LVH in itself was not associated with mortality [multivariable adjusted hazard ratio, 95{\%} CI: 0.83 (0.66-1.05), P = 0.12], but the presence of LVH combined with an EF <50{\%} was associated with the highest mortality [multivariable adjusted hazard ratios, 95{\%} CI in patients with EF >50{\%} + LVH, EF ≤50{\%}-LVH and EF ≤50{\%} + LVH, compared to EF >50{\%}-LVH: 0.84 (0.63-1.13), 1.36 (1.00-1.83) and 1.62 (1.07-2.46)].Conclusions.Low EF is associated with higher mortality in patients with NDD-CKD. In the presence of a low EF, LVH is also associated with higher mortality. Clinical trials are needed to determine if interventions targeting patients with low EF and LVH can lower mortality in NDD-CKD.",
author = "Jason Payne and Smriti Sharma and {De Leon}, Dexter and Lu, {Jun L.} and Fregenet Alemu and Balogun, {Rasheed A.} and Malakauskas, {Sandra M.} and Kamyar Kalantar-Zadeh and Csaba Kovesdy",
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T1 - Association of echocardiographic abnormalities with mortality in men with non-dialysis-dependent chronic kidney disease

AU - Payne, Jason

AU - Sharma, Smriti

AU - De Leon, Dexter

AU - Lu, Jun L.

AU - Alemu, Fregenet

AU - Balogun, Rasheed A.

AU - Malakauskas, Sandra M.

AU - Kalantar-Zadeh, Kamyar

AU - Kovesdy, Csaba

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Background. The interrelationship of left ventricular hypertrophy (LVH) with ejection fraction (EF) and their impact on mortality in non-dialysis-dependent chronic kidney disease (NDD-CKD) is unclear. Methods. We examined the associations of EF and LVH with all-cause mortality in a historic cohort of 650 male US veterans with moderate-to-advanced NDD-CKD. EF and LVH were examined both separately and after categorizing patients according to their concomitant EF and presence/absence of LVH. Associations with mortality were examined in Cox models with adjustments for demographics, blood pressure, comorbidities, smoking status, medication use and biochemical characteristics. Results. EF <30 and 30-50% were associated with higher all-cause mortality compared to EF >50% even after multivariable adjustments [multivariable adjusted hazard ratio, 95% confidence interval (CI): 2.83 (1.86-4.30) and 1.38 (1.06-1.78), P < 0.001 for linear trend]. LVH in itself was not associated with mortality [multivariable adjusted hazard ratio, 95% CI: 0.83 (0.66-1.05), P = 0.12], but the presence of LVH combined with an EF <50% was associated with the highest mortality [multivariable adjusted hazard ratios, 95% CI in patients with EF >50% + LVH, EF ≤50%-LVH and EF ≤50% + LVH, compared to EF >50%-LVH: 0.84 (0.63-1.13), 1.36 (1.00-1.83) and 1.62 (1.07-2.46)].Conclusions.Low EF is associated with higher mortality in patients with NDD-CKD. In the presence of a low EF, LVH is also associated with higher mortality. Clinical trials are needed to determine if interventions targeting patients with low EF and LVH can lower mortality in NDD-CKD.

AB - Background. The interrelationship of left ventricular hypertrophy (LVH) with ejection fraction (EF) and their impact on mortality in non-dialysis-dependent chronic kidney disease (NDD-CKD) is unclear. Methods. We examined the associations of EF and LVH with all-cause mortality in a historic cohort of 650 male US veterans with moderate-to-advanced NDD-CKD. EF and LVH were examined both separately and after categorizing patients according to their concomitant EF and presence/absence of LVH. Associations with mortality were examined in Cox models with adjustments for demographics, blood pressure, comorbidities, smoking status, medication use and biochemical characteristics. Results. EF <30 and 30-50% were associated with higher all-cause mortality compared to EF >50% even after multivariable adjustments [multivariable adjusted hazard ratio, 95% confidence interval (CI): 2.83 (1.86-4.30) and 1.38 (1.06-1.78), P < 0.001 for linear trend]. LVH in itself was not associated with mortality [multivariable adjusted hazard ratio, 95% CI: 0.83 (0.66-1.05), P = 0.12], but the presence of LVH combined with an EF <50% was associated with the highest mortality [multivariable adjusted hazard ratios, 95% CI in patients with EF >50% + LVH, EF ≤50%-LVH and EF ≤50% + LVH, compared to EF >50%-LVH: 0.84 (0.63-1.13), 1.36 (1.00-1.83) and 1.62 (1.07-2.46)].Conclusions.Low EF is associated with higher mortality in patients with NDD-CKD. In the presence of a low EF, LVH is also associated with higher mortality. Clinical trials are needed to determine if interventions targeting patients with low EF and LVH can lower mortality in NDD-CKD.

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