Monitor kidney function to reduce cardiovascular risk in CKD patients, says study

In patients with stable chronic kidney disease (CKD), the risk of cardiomyopathy caused by kidney disease appears to be greater than the risk of CKD progression due to heart disease, suggests a study, noting that these observational analyses do not establish causality.

A group of researchers examined the longitudinal association between estimated glomerular filtration rate (eGFR) and left ventricular mass index (LVMI) in 106 CKD patients across stages G1–5. 

A cross-lagged model was used to pair each predictor (eGFR or LVMI) with subsequent outcome measurements, adjusting for previous values to ensure accuracy. Overall, 257 paired LVMI and eGFR measurements were analysed during 3 years of follow-up.

The median eGFR at baseline was 54 ml/min/1.73 m², while the median LVMI was 134 g/m². Left ventricular hypertrophy (LVH) had a 62-percent prevalence.

In adjusted models, a 1-ml/min/1.73 m² reduction in eGFR resulted in an increase in LVMI of 1.12 g/m² (95 percent confidence interval, 0.71–1.54; p<0.001). Conversely, high LVMI was not predictive of a decrease in eGFR over time.

“This analysis highlights a significant risk of LVH worsening due to GFR loss, while the reverse risk does not achieve statistical significance,” said the researchers, noting “the importance of monitoring kidney function to manage cardiovascular risk in CKD patients.”

“Heart failure (HF) is known to reduce GFR, while CKD significantly increases the risk of LVH and HF,” they noted.