Stepwise Increases in Left Ventricular Mass Index and Decreases in Left Ventricular Ejection Fraction Correspond with the Stages of Chronic Kidney Disease in Diabetes Patients
Table 1
Clinical characteristics of patients among different stages of CKD.
Characteristics
Stage 3
Stage 4
Stage 5
P for trend
All patients
Age (year)
66.3 ± 12.4
68.4 ± 10.7
64.1 ± 11.5†
0.039
66.4 ± 11.6
Male gender (%)
75.8
58.6*
47.1*
<0.001
61.1
Smoking history (%)
32.3
36.4
28.7
0.540
32.6
Hypertension (%)
79.8
81.8
97.7*†
0.001
86.0
Coronary artery disease (%)
13.1
13.1
18.4
0.514
14.7
Cerebrovascular disease (%)
10.1
21.2*
27.6*
0.009
19.3
Congestive heart failure (%)
10.1
15.2
28.7*†
0.003
17.5
Systolic blood pressure (mmHg)
144.5 ± 21.2
141.2 ± 20.0
148.3 ± 23.7†
0.089
144.6 ± 21.8
Diastolic blood pressure (mmHg)
82.4 ± 12.3
77.4 ± 11.9*
76.7 ± 14.1*
0.005
78.9 ± 13.0
Pulse pressure (mmHg)
62.1 ± 16.7
63.8 ± 11.7
71.7 ± 19.9*†
0.001
65.7 ± 18.2
Body mass index (kg/m2)
26.2 ± 4.0
26.3 ± 3.5
25.0 ± 3.8*†
0.043
25.9 ± 3.8
Laboratory parameters
Albumin (g/L)
41.3 ± 3.5
39.9 ± 3.9*
37.3 ± 4.5*†
<0.001
39.6 ± 4.3
Fasting glucose (mmol/L)
8.2 ± 3.2
8.0 ± 3.8
8.3 ± 4.7
0.896
8.1 ± 3.9
HbA1c (%)
*
†
0.032
Triglyceride (mmol/L)
1.8 (1.1–2.4)
1.8 (1.4–2.6)
1.8 (1.2–2.7)
0.173
1.8 (1.2–2.6)
Total cholesterol (mmol/L)
5.0 ± 1.1
5.1 ± 1.3
5.2 ± 1.4
0.544
5.1 ± 1.3
Hemoglobin (g/L)
128.8 ± 18.7
115.4 ± 19.2*
93.1 ± 13.4*†
<0.001
113.2 ± 22.7
Baseline eGFR (mL/min/1.73 m2)
40.5 ± 6.6
23.1 ± 4.5*
10.3 ± 3.0*†
<0.001
25.2 ± 13.3
Calcium (mmol/L)
2.4 ± 0.2
2.4 ± 0.2
2.3 ± 0.2*†
<0.001
2.4 ± 0.2
Phosphate (mmol/L)
1.1 ± 0.2
1.3 ± 0.2*
1.6 ± 0.4*†
<0.001
1.3 ± 0.3
Calcium-phosphorous product (mmol2/L2)
2.8 ± 0.5
3.1 ± 0.6*
3.6 ± 0.8*†
<0.001
3.1 ± 0.7
Uric acid (μmol/L)
456.7 ± 113.3
505.4 ± 138.6*
530.8 ± 143.3*
0.001
496.5 ± 135.1
Proteinuria (%)
47.5
75.5*
98.9*†
<0.001
72.9
Medications
Aspirin use (%)
30.2
32.3
34.5
0.826
32.2
ACEI and/or ARB use (%)
80.2
83.3
63.1*†
0.003
76.1
Non-ACEI/ARB antihypertensive drug use (%)
67.7
80.8*
94.3*†
<0.001
80.4
Statin use (%)
36.5
29.2
31.0
0.532
32.2
Echocardiographic data
Aortic root diameter (cm)
3.3 ± 0.4
3.3 ± 0.4
3.2 ± 0.4
0.262
3.3 ± 0.4
LAD (cm)
3.7 ± 0.6
3.9 ± 0.6
4.1 ± 0.6*†
< 0.001
3.9 ± 0.6
LVIDd (cm)
4.8 ± 0.7
4.9 ± 0.8
5.1 ± 0.7*†
0.005
4.9 ± 0.8
LVIDs (cm)
2.9 ± 0.7
3.1 ± 0.8
3.3 ± 0.8*†
0.002
3.1 ± 0.8
LVMI (g/m2)
129.5 ± 43.5
139.1 ± 52.4
167.1 ± 45.9*†
<0.001
144.3 ± 49.8
LVH (%)
44.4
61.6*
83.9*†
<0.001
62.5
LVEF (%)
69.0 ± 11.1
67.0 ± 11.7
64.5 ± 13.2*
0.038
66.9 ± 12.1
LVEF < 55% (%)
4.0
11.1*
17.2*
0.013
10.5
(%)
78.9
84.9
75.0
0.250
79.8
CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; ACEI: angiotensin converting enzyme inhibitor; ARB: angiotensin II receptor blocker; LAD: left atrial diameter; LVIDd: left ventricular internal diameter in diastole; LVIDs: left ventricular internal diameter in systole; LVMI: left ventricular mass index; LVH: left ventricular hypertrophy; LVEF: left ventricular ejection fraction; E: peak early transmitral filling wave velocity; A: peak late transmitral filling wave velocity.
*
compared to stage 3; † compared to stage 4.
