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The effect of anemia and left ventricular geometric patterns on renal disease progression in type 2 diabetic nephropathy.

Authors
 Sung Jin Moon  ;  Ki Sun Bae  ;  Hyeong Cheon Park  ;  Jwa Kyung Kim  ;  Jung Tak Park  ;  Jung Eun Lee  ;  Se Joong Rim,  ;  Sung Kyu Ha 
Citation
 JOURNAL OF NEPHROLOGY, Vol.24(1) : 50-59, 2011 
Journal Title
JOURNAL OF NEPHROLOGY
ISSN
 1121-8428 
Issue Date
2011
MeSH
Anemia/blood ; Anemia/complications* ; Anemia/drug therapy ; Chi-Square Distribution ; Diabetes Mellitus, Type 2/complications* ; Diabetic Nephropathies/blood ; Diabetic Nephropathies/etiology* ; Diabetic Nephropathies/physiopathology ; Diabetic Nephropathies/therapy ; Disease Progression ; Female ; Glomerular Filtration Rate ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Hematinics/therapeutic use ; Hemoglobins/metabolism ; Humans ; Hypertrophy, Left Ventricular/complications* ; Hypertrophy, Left Ventricular/diagnostic imaging ; Hypertrophy, Left Ventricular/physiopathology ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/blood ; Kidney Failure, Chronic/etiology* ; Kidney Failure, Chronic/physiopathology ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Proportional Hazards Models ; Renal Replacement Therapy ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Ultrasonography ; Ventricular Remodeling
Keywords
Anemia ; Diabetic nephropathy ; Left ventricular hypertrophy ; Renal disease progression
Abstract
BACKGROUND: Left ventricular (LV) geometric patterns have never been evaluated as independent risk factors for renal disease progression (RDP). We investigated the risk factors for RDP in type 2 diabetic nephropathy patients, especially focusing on the effects of LV geometric patterns.

METHODS: This was a single-center retrospective cohort study. Type 2 diabetic nephropathy patients who underwent echocardiography for routine checkup were recruited. Baseline laboratory data within 1 month from the time of echocardiography and clinical and follow-up laboratory data were collected by retrospective reviews.

RESULTS: A total of 150 patients (90 men, mean age 62.9 years) were enrolled. Distributions of the patients according to LV geometric patterns were as follows: normal 21 (14.0%), concentric remodeling 18 (12.0%), concentric hypertrophy 70 (46.7%) and eccentric hypertrophy 41 (27.3%). During the study period (30.1 ± 19.4 months), RDP developed in 53 of 150 patients (35.3%). On univariate analysis, use of erythropoiesis-stimulating agent, hemoglobin, serum creatinine, estimated glomerular filtration rate (eGFR), serum albumin, log-transformed 24-hour urine protein, LV mass index and eccentric hypertrophy were strong predictors of renal outcomes. RDP-free survival was significantly decreased in the eccentric hypertrophy group (p=0.001, vs. other groups) according to Kaplan-Meier analysis. On multivariate analysis, eGFR, eccentric hypertrophy and hemoglobin levels were significant predictors of renal outcome.

CONCLUSION: Anemia and eccentric hypertrophy may be considered as important risk factors for RDP. Multicenter prospective trials should be needed to validate the effect of LV geometric patterns on RDP.
Full Text
http://www.jnephrol.com/article/the-effect-of-anemia-and-left-ventricular-geometric-patterns-on-renal-disease-progression-in-type-2-diabetic-nephropathy-jnephrol-09-00159
DOI
10.5301/JN.2010.353
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jwa Kyung(김좌경)
Moon, Sung Jin(문성진)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Bae, Ki Sun(배기선)
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Ha, Sung Kyu(하성규)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94021
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