Renal Outcomes Linked to LVMI

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NEW YORK—In men at high risk of cardiovascular events, left ventricular mass index (LVMI) may help better predict renal outcomes, including the need for hemodialysis (HD), researchers reported here at the American Society of Hypertension 25th Annual Scientific Meeting and Exposition.

Left ventricular hypertrophy (LVH) is becoming common in patients with renal dysfunction. Additionally, a substantial amount of evidence has documented a strong association between impaired renal function and adverse cardiovascular events, including myocardial infarction (MI) and stroke.

In a study conducted at the VA Medical Center in Washington, D.C., researchers retrospectively studied 6,163 men (mean age 68 years) for 14 years. The vast majority of the men were hypertensive, 80% were African Americans, and 30% were smokers.  The investigators assessed subjects' left ventricular mass index (LVMI) at baseline and measured kidney function and BP levels at baseline and at the end of the 14-year follow-up period.

The study showed that each 42 g/m2 increase in LVMI was associated with a 45.7% increased risk of a doubling of serum creatinine, a 51.9% increased risk of having an estimated glomerular filtration rate below 30 mL/min/1.73 m2, and a 58.3% increased risk for needing HD.

In addition, patients with at least moderate LVH (LVMI greater than 125 g/m2) showed a marked decline in kidney function compared with those without LVH (LVMI below 110 g/m2).

“In men with high cardiovascular risk, the severity of LVH could be a useful clinical tool in determining the decline of kidney function, including the increased probability for hemodialysis,” said investigator Costas Tsioufis, MD, now with the University of Athens' Hippokration Hospital in Greece.

“These results underline that at least moderate cardiac hypertrophy substantially accelerates the development of adverse renal outcomes, further suggesting that minor degrees of hypertrophy could constitute the appropriate time period to act for protecting kidneys from progressive damage.”

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