Left Ventricular Mass in Dialysis Patients, Determinants and Relation with Outcome. Results from the COnvective TRansport STudy (CONTRAST)

PLoS One

Renée Levesque¹  Otto Kamp²  Marinus A. van den Dorpel²  Piet M. ter Wee³  Albert H. A. Mazairac⁴  E. Lars Penne⁵  Claire H. den Hoedt⁵  Dorine W. Swinkels⁵  Menso J. Nubé⁵  Ira M. Mostovaya⁵  Neelke C. van der Weerd⁶  Muriel P. C. Grooteman⁶  Peter J. Blankestijn⁶  Roel Goldschmeding⁷  Michiel L. Bots⁸ 

[1] Department of Cardiology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands;Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands;Department of Laboratory Medicine, Laboratory of Genetic, Endocrine and Metabolic diseases, Radboud University Medical Centre Nijmegen, the Netherlands;Department of Nephrology, Centre Hospitalier de l'Université de Montréal St. Luc Hospital, Montréal, Canada;Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands;Department of Nephrology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands;Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands;Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

关键词: Medical dialysis;    Chronic kidney disease;    Phosphates;    Cardiovascular diseases;    Death rates;    Echocardiography;    Biomarkers;    Fibrosis;   

DOI  :  10.1371/journal.pone.0084587

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Background and Objectives Left ventricular mass (LVM) is known to be related to overall and cardiovascular mortality in end stage kidney disease (ESKD) patients. The aims of the present study are 1) to determine whether LVM is associated with mortality and various cardiovascular events and 2) to identify determinants of LVM including biomarkers of inflammation and fibrosis.Design, Setting, Participants, & Measurements Analysis was performed with data of 327 ESKD patients, a subset from the CONvective TRAnsport STudy (CONTRAST). Echocardiography was performed at baseline. Cox regression analysis was used to assess the relation of LVM tertiles with clinical events. Multivariable linear regression models were used to identify factors associated with LVM.Results Median age was 65 (IQR: 54–73) years, 203 (61%) were male and median LVM was 227 (IQR: 183–279) grams. The risk of all-cause mortality (hazard ratio (HR) = 1.73, 95% CI: 1.11–2.99), cardiovascular death (HR = 3.66, 95% CI: 1.35–10.05) and sudden death (HR = 13.06; 95% CI: 6.60–107) was increased in the highest tertile (>260grams) of LVM. In the multivariable analysis positive relations with LVM were found for male gender (B = 38.8±10.3), residual renal function (B = 17.9±8.0), phosphate binder therapy (B = 16.9±8.5), and an inverse relation for a previous kidney transplantation (B = −41.1±7.6) and albumin (B = −2.9±1.1). Interleukin-6 (Il-6), high-sensitivity C-reactive protein (hsCRP), hepcidin-25 and connective tissue growth factor (CTGF) were not related to LVM.Conclusion We confirm the relation between a high LVM and outcome and expand the evidence for increased risk of sudden death. No relationship was found between LVM and markers of inflammation and fibrosis.Trial Registration Controlled-Trials.com ISRCTN38365125.

【 授权许可】

CC BY