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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  ;  Sung Kyu Ha  ;  Se Joong Rim,  ;  Jung Eun Lee  ;  Jung Tak Park  ;  Jwa Kyung Kim  ;  Hyeong Cheon Park 
 Journal of Nephrology, Vol.24(1) : 50-59, 2011 
Journal Title
 Journal of Nephrology 
Issue Date
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. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김좌경(Kim, Jwa Kyung) ; 문성진(Moon, Sung Jin) ; 박정탁(Park, Jung Tak) ; 박형천(Park, Hyeong Cheon) ; 배기선(Bae, Ki Sun) ; 이정은(Lee, Jung Eun) ; 임세중(Rim, Se Joong) ; 하성규(Ha, Sung Kyu)
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