Factors associated with risk analysis for asymptomatic left ventricular diastolic dysfunction in nondialysis patients with chronic kidney disease.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-05-24 DOI:10.1080/0886022X.2024.2353334
Yajuan Gao, Shengnan Chen, Jiani Fu, Cui Wang, Yali Tang, Yongbai Luo, Xiaozhen Zhuo, Xueying Chen, Yan Shen
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Abstract

Heart failure (HF) constitutes a major determinant of outcome in chronic kidney disease (CKD) patients. The main pattern of HF in CKD patients is preserved ejection fraction (HFpEF), and left ventricular diastolic dysfunction (LVDD) is a frequent pathophysiological mechanism and specific preclinical manifestation of HFpEF. Therefore, exploring and intervention of the factors associated with risk for LVDD is of great importance in reducing the morbidity and mortality of cardiovascular disease (CVD) complications in CKD patients. We designed this retrospective cross-sectional study to collect clinical and echocardiographic data from 339 nondialysis CKD patients without obvious symptoms of HF to analyze the proportion of asymptomatic left ventricular diastolic dysfunction (ALVDD) and its related factors associated with risk by multivariate logistic regression analysis. Among the 339 nondialysis CKD patients, 92.04% had ALVDD. With the progression of CKD stage, the proportion of ALVDD gradually increased. The multivariate logistic regression analysis revealed that increased age (OR 1.237; 95% confidence interval (CI) 1.108-1.381, per year), diabetic nephropathy (DN) and hypertensive nephropathy (HTN) (OR 25.000; 95% CI 1.355-48.645, DN and HTN vs chronic interstitial nephritis), progression of CKD stage (OR 2.785; 95% CI 1.228-6.315, per stage), increased mean arterial pressure (OR 1.154; 95% CI 1.051-1.268, per mmHg), increased urinary protein (OR 2.825; 95% CI 1.484-5.405, per g/24 h), and low blood calcium (OR 0.072; 95% CI 0.006-0.859, per mmol/L) were factors associated with risk for ALVDD in nondialysis CKD patients after adjusting for other confounding factors. Therefore, dynamic monitoring of these factors associated with risk, timely diagnosis and treatment of ALVDD can delay the progression to symptomatic HF, which is of great importance for reducing CVD mortality, and improving the prognosis and quality of life in CKD patients.

非透析慢性肾病患者无症状左心室舒张功能障碍风险分析的相关因素。
心力衰竭(HF)是慢性肾脏病(CKD)患者预后的主要决定因素。CKD 患者心力衰竭的主要模式是射血分数保留(HFpEF),而左心室舒张功能障碍(LVDD)是 HFpEF 常见的病理生理机制和特殊的临床前表现。因此,探索和干预与 LVDD 相关的风险因素对降低 CKD 患者心血管疾病(CVD)并发症的发病率和死亡率具有重要意义。我们设计了这项回顾性横断面研究,收集了 339 名无明显心房颤动症状的非透析 CKD 患者的临床和超声心动图数据,通过多变量逻辑回归分析,分析无症状左室舒张功能障碍(ALVDD)的比例及其相关风险因素。在339名非透析的慢性肾脏病患者中,92.04%患有ALVDD。随着 CKD 分期的进展,ALVDD 的比例逐渐增加。多变量逻辑回归分析显示,年龄增加(OR 1.237; 95% 置信区间 (CI) 1.108-1.381, 每年)、糖尿病肾病(DN)和高血压肾病(HTN)(OR 25.000; 95% CI 1.355-48.645, DN 和 HTN vs 慢性间质性肾炎)、CKD 分期进展(OR 2.785; 95% CI 1.228-6.315,每期)、平均动脉压升高(OR 1.154;95% CI 1.051-1.268,每 mmHg)、尿蛋白升高(OR 2.825;95% CI 1.484-5.405,每 g/24 h)和低血钙(OR 0.072;95% CI 0.006-0.859,每 mmol/L)是非透析 CKD 患者在调整其他混杂因素后发生 ALVDD 风险的相关因素。因此,动态监测这些与风险相关的因素,及时诊断和治疗 ALVDD,可以延缓进展为有症状的高血压,这对于降低心血管疾病死亡率、改善 CKD 患者的预后和生活质量具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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