Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease

Background: Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined. Methods: We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3-5 CKD. LVH was defined as LVMI > 125 g/m² in male patients and >110 g/m² in female patients. Results: We analyzed baseline characteristics in 1185 participants (male 63.7 %, female 36.3 %). Diabetes mellitus was the underlying disease in 41.3 % of patients, and mean age was 61.8 ± 11.1 years. LVH was detected in 21.7 % of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95 % confidence interval [CI] 0.360-0.916; P = 0.020), systolic blood pressure (OR 1.179; 95 % CI 1.021-1.360; P = 0.025), body mass index (OR 1.135; 95 % CI 1.074-1.200; P < 0.001), and serum calcium level (OR 0.589; 95 % CI 0.396-0.876; P = 0.009). Conclusion: Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.