Volume 22 Issue 8
Aug.  2024
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XIAO Zhimei, DING Chenhui, LUO Chen, QIAN Leilei. Risk factors of left ventricular hypertrophy for chronic kidney disease patients and construction of a predictive model[J]. Chinese Journal of General Practice, 2024, 22(8): 1354-1358. doi: 10.16766/j.cnki.issn.1674-4152.003635
Citation: XIAO Zhimei, DING Chenhui, LUO Chen, QIAN Leilei. Risk factors of left ventricular hypertrophy for chronic kidney disease patients and construction of a predictive model[J]. Chinese Journal of General Practice, 2024, 22(8): 1354-1358. doi: 10.16766/j.cnki.issn.1674-4152.003635

Risk factors of left ventricular hypertrophy for chronic kidney disease patients and construction of a predictive model

doi: 10.16766/j.cnki.issn.1674-4152.003635
Funds:

 LGY201926

 QA2020051

  • Received Date: 2023-09-25
    Available Online: 2024-11-19
  •   Objective  To construct a predictive model for assessing the risk of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD) and evaluate its clinical application value.  Methods  The clinical data of 302 patients with stage Ⅲ-Ⅴ CKD, who were treated at Rugao Hospital Affiliated to Nantong University from January 2018 to August 2022 were collected. Patients were randomly divided into a modeling group (n=200) and a validation group (n=102) based on their ID number. Logistic regression was used to determine risk factors for LVH, and a nomogram model was constructed. The predictive ability of the model was evaluated by receiver operating characteristic curve and correction curve.  Results  The incidence of LVH in CKD patients was 37.4% (113/302). Older age (OR=1.054, 95% CI: 1.020-1.089, P=0.002), cardiovascular history (OR=5.826, 95% CI: 2.263-15.003, P < 0.001), CKD Ⅴ stage (OR=5.831, 95% CI: 2.142-15.873, P=0.009), elevated systolic blood pressure (OR=1.019, 95% CI: 1.002-1.036, P=0.025) and hyperphosphatemia (OR=1.109, 95% CI: 1.029-1.195, P=0.007) were independent risk factors for LVH. The prediction model of LVH was constructed based on the above factors, and had AUC of 0.850 (95% CI: 0.796-0.904) in the modeling group and 0.792 (95% CI: 0.707-0.877) in validation group. The calibration curve showed that the nomogram model exhibits good predictive ability for LVH.  Conclusion  The nomogram model, which is based on age, history of cardiovascular disease, CKD stage, systolic blood pressure, and blood phosphorus, provides clinicians a simple and effective tool to identify CKD patients with high risk of LVH.

     

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  • [1]
    KURTH T, DE JONG P E, COOK N R, et al. Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study[J]. BMJ, 2009, 338: b2392. DOI: 10.1136/bmj.b2392.
    [2]
    POULIKAKOS D, ROSS L, RECIO-MAYORAL A, et al. Left ventricular hypertrophy and endothelial dysfunction in chronic kidney disease[J]. Eur Heart J Cardiovasc Imaging, 2014, 15(1): 56-61. doi: 10.1093/ehjci/jet120
    [3]
    NARDI E, MULÈ G, GIAMMANCO A, et al. Left ventricular hypertrophy in chronic kidney disease: a diagnostic criteria comparison[J]. Nutr Metab Cardiovasc Dis, 2021, 31(1): 137-144. doi: 10.1016/j.numecd.2020.08.028
    [4]
    WANG J, LV J, HE K, et al. Association of left ventricular hypertrophy and functional impairment with cardiovascular outcomes and mortality among patients with chronic kidney disease, results from the C-STRIDE study[J]. Nephrology (Carlton), 2022, 27(4): 327-336. doi: 10.1111/nep.14009
    [5]
    AHMAD F S, CAI X, KUNKEL K, et al. Racial/Ethnic differences in left ventricular structure and function in chronic kidney disease: the chronic renal insufficiency cohort[J]. Am J Hypertens, 2017, 30(8): 822-829. doi: 10.1093/ajh/hpx058
    [6]
    BUSSALINO E, RAVERA M, MINUTOLO R, et al. A new CHA2D S2VASC score integrated with estimated glomerular filtration rate, left ventricular hypertrophy, and pulse pressure is highly effective in predicting adverse cardiovascular outcome in chronic kidney disease[J]. Eur J Prev Cardiol, 2022, 29(8): e275-e278. doi: 10.1093/eurjpc/zwac039
    [7]
    余福海, 沈才杰, 陆曹杰, 等. 慢性肾脏病患者心率变异性相关影响因素及预防对策[J]. 中华全科医学, 2021, 19(5): 798-800, 855. doi: 10.16766/j.cnki.issn.1674-4152.001920

    YU F H, SHEN C J, LU C J, et al. Related influencing factors and preventive measures of heart rate variability in patients uffer from chronic kidney disease[J]. Chinese Journal of General Practice, 2021, 19(5): 798-800, 855. doi: 10.16766/j.cnki.issn.1674-4152.001920
    [8]
    NITTA K, IIMURO S, IMAI E, et al. Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease: findings from the CKD-JAC study[J]. Clin Exp Nephrol, 2019, 23(1): 85-98. doi: 10.1007/s10157-018-1605-z
    [9]
    KIM I Y, YE B M, KIM M J, et al. Association between serum uric acid and left ventricular hypertrophy/left ventricular diastolic dysfunction in patients with chronic kidney disease[J]. PLoS One, 2021, 16(5): e0251333. DOI: 10.1371/journal.pone.0251333.
    [10]
    YE C, WANG T, GONG J, et al. Development of a nomogram for screening the risk of left ventricular hypertrophy in Chinese hypertensive patients[J]. J Clin Hypertens (Greenwich), 2021, 23(6): 1176-1185. doi: 10.1111/jch.14240
    [11]
    STEVENS P E, LEVIN A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline[J]. Ann Intern Med, 2013, 158(11): 825-830. doi: 10.7326/0003-4819-158-11-201306040-00007
    [12]
    REICHEK N, DEVEREUX R B. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings[J]. Circulation, 1981, 63(6): 1391-1398. doi: 10.1161/01.CIR.63.6.1391
    [13]
    MATSUO S, IMAI E, HORIO M, et al. Revised equations for estimated GFR from serum creatinine in Japan[J]. Am J Kidney Dis, 2009, 53(6): 982-992. doi: 10.1053/j.ajkd.2008.12.034
    [14]
    LANG R M, BADANO L P, MOR-AVI V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. J Am Soc Echocardiogr, 2015, 28(1): 1-39. e14. DOI: 10.1016/j.echo.2014.10.003.
    [15]
    THOMPSON S, JAMES M, WIEBE N, et al. Cause of death in patients with reduced kidney function[J]. J Am Soc Nephrol, 2015, 26(10): 2504-2511. doi: 10.1681/ASN.2014070714
    [16]
    TANAKA F, KOMI R, NAKAMURA M, et al. Additional prognostic value of electrocardiographic left ventricular hypertrophy in traditional cardiovascular risk assessments in chronic kidney disease[J]. J Hypertens, 2020, 38(6): 1149-1157. doi: 10.1097/HJH.0000000000002394
    [17]
    WU Z, SHI M, WANG L, et al. Identification of major risk factors and non-linear effects to the development of left ventricular hypertrophy in chronic kidney disease by constructing and validation of nomograms[J]. Front Med (Lausanne), 2022, 9(6): 914800. DOI: 10.3389/fmed.2022.914800.
    [18]
    AMOAKO Y A, LARYEA D O, BEDU-ADDO G, et al. Left ventricular hypertrophy among chronic kidney disease patients in Ghana[J]. Pan Afr Med J, 2017, 28(9): 79. DOI: 10.11604/pamj.2017.28.79.9183.
    [19]
    CHAO C T, LIAO M T, WU C K. Left ventricular hypertrophy geometry and vascular calcification co-modify the risk of cardiovascular mortality in patients with end-stage kidney disease: a retrospective cohort study[J]. J Atheroscler Thromb, 2023, 30(9): 1242-1254. doi: 10.5551/jat.63870
    [20]
    RITZ E. Left ventricular hypertrophy in renal disease: beyond preload and afterload[J]. Kidney Int, 2009, 75(8): 771-773. doi: 10.1038/ki.2009.35
    [21]
    叶霖, 吴玉娟, 王玉翠. 慢性肾功能不全合并左心室肥厚相关因素分析[J]. 中国预防医学杂志, 2019, 20(11): 1125-1128.

    YE L, WU Y J, WANG Y C, et al. Analysis of factors related to chronic renal insufficiency combined with left ventricular hypertrophy[J]. China Preventive Medicine, 2019, 20(11): 1125-1128.
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