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

 Sung Jin Moon  ;  Ki Sun Bae  ;  Hyeong Cheon Park  ;  Jwa Kyung Kim  ;  Jung Tak Park  ;  Jung Eun Lee  ;  Se Joong Rim,  ;  Sung Kyu Ha 
 JOURNAL OF NEPHROLOGY, Vol.24(1) : 50-59, 2011 
Journal Title
Issue Date
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
Anemia ; Diabetic nephropathy ; Left ventricular hypertrophy ; Renal disease progression
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.
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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)
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