Introduction
Methods
Population
Clinical characteristics
Echocardiography
Statistical analysis
Results
Control | DN | Hypertensive or renovascular nephropathy | tubulointerstitial nephritis | Glomerulonephritis or vasculitis | PKD | CKDu | p | |
---|---|---|---|---|---|---|---|---|
n | 174 | 90 | 43 | 12 | 249 | 109 | 206 | |
Male sex, n (%) | 107 (61.5) | 62 (68.9) | 26 (60.5) | 8 (66.7) | 162 (65.1) | 59 (54.1) | 142 (68.9) | 0.2 |
Age, years, mean ± SD | 59.3 ± 12.2 | 62.5 ± 9.1 | 58.7 ± 13.3 | 59.6 ± 11.5 | 53.9 ± 13.2 | 51.5 ± 12.1 | 62.6 ± 10.8 | < 0.001 |
Smoking status, n (%) | 0.2 | |||||||
- Never | 88 (50.6) | 40 (44.4) | 16 (37.2) | 4 (33.3) | 104 (41.8) | 43 (39.4) | 75 (36.4) | |
- Former | 68 (39.1) | 35 (38.9) | 16 (37.2) | 6 (50.0) | 102 (41.0) | 48 (44.0) | 0 (0.0) | |
- Active | 18 (10.3) | 15 (16.7) | 10 (23.3) | 2 (16.7) | 42 (16.9) | 18 (16.5) | 40 (19.4) | |
Alcohol consumption, drinks/week, median [IQR] | 1 [0, 7.5] | 2 [0, 6] | 1.5 [0, 10] | 2 [0, 7] | 2 [0, 10] | < 0.001 | ||
Physical activity level, n (%) | < 0.001 | |||||||
- Low | 10 (5.7) | 25 (27.8) | 10 (23.3) | 1 (8.3) | 21 (8.4) | 6 (5.5) | 33 (16) | |
- Moderate | 30 (17.2) | 22 (24.4) | 12 (27.9) | 4 (33.3) | 57 (22.9) | 20 (18.3) | 58 (28.2) | |
- High moderate | 93 (53.4) | 36 (40.0) | 19 (44.2) | 5 (41.7) | 129 (51.8) | 65 (59.6) | 94 (45.6) | |
- High | 41 (23.6) | 7 (7.8) | 2 (4.7) | 2 (16.7) | 42 (16.9) | 18 (16.5) | 21 (10.2) | |
Heart rate, BPM, mean ± SD | 70.2 ± 11.3 | 72.8 ± 12.8 | 73.4 ± 15.4 | 75.1 ± 9.6 | 74.1 ± 13.3 | 69.1 ± 12.3 | 71.7 ± 13.5 | 0.01 |
Hypertension, n (%) | 56 (32.2) | 80 (88.9) | 41 (95.3) | 9 (75.0) | 202 (81.1) | 94 (86.2) | 180 (87.4) | < 0.001 |
Systolic BP, mmHg, mean ± SD | 130.0 ± 16.9 | 136.6 ± 20.9 | 132.3 ± 19.5 | 121.1 ± 15.7) | 129.7 ± 16.3 | 130.6 ± 15.6 | 134.6 ± 17.6 | 0.003 |
Diastolic BP, mmHg, mean ± SD | 81.7 ± 8.9 | 75.2 ± 11.9 | 81.6 ± 11.3 | 75.9 ± 10.5 | 81.5 ± 9.7 | 84.0 ± 9.4 | 80.8 ± 11.3 | < 0.001 |
BMI, kg/m2, mean ± SD | 25.3 ± 3.3 | 32.2 ± 6.9 | 28.9 ± 5.9 | 30.8 ± 7.7 | 27.9 ± 5.6 | 26.7 ± 4.7 | 29.1 ± 5.9 | < 0.001 |
Diabetes, n (%) | 0 (0) | 90 (100) | 10 (23.3) | 4 (33.3) | 23 (9.2) | 5 (4.6) | 28 (13.6) | < 0.001 |
HbA1c, median [IQR] | 35 [32, 36] | 54 [47, 65] | 38 [35, 43] | 41 [36, 43] | 37 [34, 40] | 35 [33, 38] | 37 [35, 42] | < 0.001 |
Total plasma cholesterol, mmol/L, mean ± SD | 5.6 ± 1.0 | 4.3 ± 1.1 | 5.0 ± 1.1 | 5.1 ± 1.7 | 5.6 ± 1.3 | 5.1 ± 1.0 | 4.9 ± 1.1 | < 0.001 |
Cardiovascular disease, n (%) | 0 (0) | 39 (43.3) | 8 (18.6) | 1 (8.3) | 5 (2.0) | 1 (0.9) | 56 (27.2) | < 0.001 |
Heart failure, n (%) | 0 (0) | 24 (26.7) | 8 (18.6) | 1 (8.3) | 5 (2) | 1 (0.9) | 34 (10.6) | < 0.001 |
Previous myocardial infarction, n (%) | 0 (0) | 9 (10.0) | 3 (7.0) | 1 (8.3) | 7 (2.8) | 1 (0.9) | 12 (5.8) | 0.005 |
Significant valve disease, n (%) | 0 (0) | 10 (11.1) | 1 (2.3) | 0 (0.0) | 4 (1.6) | 1 (0.9) | 16 (5.0) | < 0.001 |
Previous stroke, n (%) | 0 (0) | 18 (20.0) | 6 (14.0) | 0 (0.0) | 11 (4.4) | 6 (5.5) | 41 (12.7) | < 0.001 |
Peripheral artery disease, n (%) | 0 (0) | 10 (11.1) | 8 (18.6) | 1 (8.3) | 3 (1.2) | 1 (0.9) | 16 (5.0) | < 0.001 |
Kidney biopsy, yes, n (%) | 0 (0) | 10 (11.1) | 12 (27.9) | 6 (50.0) | 78 (31.3) | 0 (0.0) | 0 (0.0) | < 0.001 |
eGFR, median [IQR] | 81 [73, 91] | 35 [22.2, 41.8] | 31 [22, 44.5] | 26.5 [17.2, 34.8] | 51 [36, 77] | 54 [24, 79] | 39.5 [27, 53] | < 0.001 |
eGFR stage, n (%) | < 0.001 | |||||||
- Control | 174 (0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
- Stage 1 | 0 (0) | 1 (1.1) | 0 (0.0) | 0 (0.0) | 39 (15.7) | 19 (17.4) | 16 (5.0) | |
- Stage 2 | 0 (0) | 4 (4.4) | 1 (2.3) | 0 (0.0) | 63 (25.3) | 28 (25.7) | 41 (12.7) | |
- Stage 3a | 0 (0) | 14 (15.6) | 10 (23.3) | 2 (16.7) | 49 (19.7) | 17 (15.6) | 66 (20.5) | |
- Stage 3b | 0 (0) | 35 (38.9) | 12 (27.9) | 4 (33.3) | 58 (23.3) | 12 (11.0) | 106 (32.9) | |
- Stage 4 | 0 (0) | 27 (30.0) | 16 (37.2) | 4 (33.3) | 36 (14.5) | 20 (18.3) | 76 (23.6) | |
- Stage 5 | 0 (0) | 9 (10.0) | 4 (9.3) | 2 (16.7) | 4 (1.6) | 13 (11.9) | 17 (5.3) | |
UACR, median [IQR] | 245.5 [39, 1,514.8] | 161 [12, 1,036] | 46 [5.5, 177] | 327 [55, 922] | 26 [13, 90] | 101 [16, 453] | < 0.001 | |
Albuminuria status, mg/g, n (%) | < 0.001 | |||||||
- None or mild | 173 (99.4) | 25 (27.8) | 15 (34.9) | 6 (50.0) | 48 (19.3) | 62 (56.9) | 120 (37.3) | |
- Moderate | 1 (0.6) | 25 (27.8) | 11 (25.6) | 4 (33.3) | 75 (30.1) | 34 (31.2) | 103 (32.0) | |
- Severe | 0 (0) | 40 (44.4) | 17 (39.5) | 2 (16.7) | 126 (50.6) | 13 (11.9) | 99 (30.7) |
Echocardiographic findings
Control | CKD | p | Fitteda control | Fitteda CKD | Adj. pb | |
---|---|---|---|---|---|---|
LVEF, %, median [IQR] | ||||||
DN | 60.8 [57.7, 64.1] | 56.0 [49.9, 60.6] | < 0.001 | 60.7 [60, 61.8] | 54.2 [51.7, 55.7] | < 0.001 |
CKDu | 60.8 [57.7, 64.1] | 59.5 [53.8,63.1] | 0.006 | 60.7 [60, 61.8] | 58.8 [55.8, 59.9] | < 0.001 |
GLS, %, mean ± SD | ||||||
DN | 15.5 ± 2.6 | 13.1 ± 3.5 | < 0.001 | 15.6 ± 1.1 | 13.6 ± 1.3 | < 0.001 |
Hypertensive or renovascular nephropathy | 15.5 ± 2.6 | 13.3 ± 3.8 | 0.011 | 15.6 ± 1.1 | 15 ± 2.2 | 0.351 |
CKDu | 15.5 ± 2.6 | 14.1 ± 3 | < 0.001 | 15.6 ± 1.1 | 14.8 ± 1.4 | < 0.001 |
PKD | 15.5 ± 2.6 | 16.5 ± 2.7 | 0.016 | 15.6 ± 1.1 | 16.2 ± 1.4 | 0.001 |
GAS, %, mean ± SD | ||||||
DN | 28.5 ± 4.2 | 24.1 ± 5.8 | < 0.001 | 28.6 ± 1.4 | 24.9 ± 2 | < 0.001 |
Hypertensive or renovascular nephropathy | 28.5 ± 4.2 | 25.3 ± 6.2 | 0.036 | 28.6 ± 1.4 | 26.9 ± 2.7 | 0.025 |
CKDu | 28.5 ± 4.2 | 26.5 ± 5.2 | 0.001 | 28.6 ± 1.4 | 27.3 ± 2 | < 0.001 |
GRS, %, mean ± SD | ||||||
DN | 44.1 ± 9.7 | 36.2 ± 11.2 | < 0.001 | 44.6 ± 3.1 | 38.8 ± 4.2 | < 0.001 |
LVMi, g/m2, median [IQR] | ||||||
DN | 69 [57.9, 80.8] | 89.1 [71.8, 104.9] | < 0.001 | 69.5 [62.6, 76.4] | 92.7 [86.5, 97.8] | < 0.001 |
CKDu | 69 [57.9, 80.8] | 80.6 [66.3,96.1] | < 0.001 | 69.5 [62.6, 76.4] | 82.4 [75.1, 88.6] | < 0.001 |
Glomerulonephritis or vasculitis | 69 [57.9, 80.8] | 72.8 [62.6, 87.6] | 0.031 | 69.5 [62.6, 76.4] | 77.8 [70.1, 83.7] | < 0.001 |
E/e’ ratio, median [IQR] | ||||||
DN | 7 [5.8, 8.3] | 10.6 [8.5, 12.6] | < 0.001 | 7.5 [6.8, 7.9] | 11.4 [10.1, 12.3] | < 0.001 |
Hypertensive or renovascular nephropathy | 7 [5.8, 8.3] | 8.6 [6.4, 10.2] | 0.005 | 7.5 [6.8, 7.9] | 8.9 [7.5, 10.4] | < 0.001 |
CKDu | 7 [5.8, 8.3] | 8.4 [7.2,10.4] | < 0.001 | 7.5 [6.8, 7.9] | 8.8 [7.9, 10.2] | < 0.001 |
Group | eGFR | Albuminuria | ||||
---|---|---|---|---|---|---|
Stage 1 and 2 | Stage 3 | Stage 4 and 5 | A1 | A2 | A3 | |
Diabetic nephropathy | 5 | 49 | 36 | 25 | 25 | 40 |
Glomerulonephritis or vasculitis | 34 | 112 | 60 | 48 | 75 | 126 |
Hypertensive/renovascular nephropathy | 1 | 22 | 20 | 15 | 11 | 17 |
CKD of unknown origin | 102 | 107 | 40 | 83 | 64 | 59 |
Polycystic kidney disease | 47 | 29 | 33 | 62 | 34 | 13 |
Tubulointerstitial nephropathy | 0 | 6 | 6 | 6 | 4 | 2 |