Clinical and Experimental Nephrology

, Volume 17, Issue 5, pp 730–742 | Cite as

RETRACTED ARTICLE: Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease

  • Kosaku NittaEmail author
  • Satoshi Iimuro
  • Enyu Imai
  • Seiichi Matsuo
  • Hirofumi Makino
  • Tadao Akizawa
  • Tsuyoshi Watanabe
  • Yasuo Ohashi
  • Akira Hishida
Original Article



Although left ventricular hypertrophy (LVH) has been established as a predictor of cardiovascular events in chronic kidney disease (CKD), the relationship between the prevalence of LVH and CKD stage during the predialysis period has not been fully examined.


We measured left ventricular mass index (LVMI) in a cross-sectional cohort of participants in the Chronic Kidney Disease Japan Cohort (CKD-JAC) study in order to identify factors that are associated with increased LVMI in patients with stage 3–5 CKD. LVH was defined as LVMI > 125 g/m2 in male patients and >110 g/m2 in female patients.


We analyzed baseline characteristics in 1185 participants (male 63.7 %, female 36.3 %). Diabetes mellitus was the underlying disease in 41.3 % of patients, and mean age was 61.8 ± 11.1 years. LVH was detected in 21.7 % of patients at baseline. By multivariate logistic analysis, independent risk factors for LVH were past history of cardiovascular disease (odds ratio [OR] 0.574; 95 % confidence interval [CI] 0.360–0.916; P = 0.020), systolic blood pressure (OR 1.179; 95 % CI 1.021–1.360; P = 0.025), body mass index (OR 1.135; 95 % CI 1.074–1.200; P < 0.001), and serum calcium level (OR 0.589; 95 % CI 0.396–0.876; P = 0.009).


Cross-sectional baseline data from the CKD-JAC study shed light on the association between LVH and risk factors in patients with decreased renal function. Further longitudinal analyses of the CKD-JAC cohort are needed to evaluate the prognostic value of LVH in CKD patients.


Chronic kidney disease Left ventricular hypertrophy Hypertension Body mass index Albuminuria Mineral metabolism Antihypertensive agent 



This study was conducted by principal investigators at the following medical centers: Yoshio Taguma; Sendai Social Insurance Hospital (Miyagi), Yoshitaka Maeda; JA Toride Medical Center (Ibaragi), Eiji Kusano; Jichi Medical University (Tochigi), Yasuhiro Komatsu; St. Luke’s International Hospital (Tokyo), Tadao Akizawa; Showa University Hospital (Tokyo), Eriko Kinugasa; Showa University Yokohama Northern Hospital (Kanagawa), Ashio Yoshimura; Showa University Fujigaoka Hospital (Kanagawa), Hiroshige Ohashi, Hiroshi Oda; Gifu Prefectural General Medical Center (Gifu), Yuzo Watanabe; Kasugai Municipal Hospital (Aichi), Daijo Inaguma, Kei Kurata; Tosei General Hospital (Aichi), Yoshitaka Isaka; Osaka University Hospital (Osaka), Yoshiharu Tsubakihara; Osaka General Medical Center (Osaka), Masahito Imanishi; Osaka City General Hospital (Osaka), Masaki Fukushima; Kurashiki Central Hospital (Okayama), Hideki Hirakata; Fukuoka Red Cross Hospital (Fukuoka), Kazuhito Takeda; Iizuka Hospital (Fukuoka).


  1. 1.
    National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evidence, classification, and stratification. Am J Kidney Dis. 2002;39(suppl 1):S1–266.Google Scholar
  2. 2.
    Japanese Society of Dialysis Therapy. An overview of regular dialysis treatment in Japan as of Dec 31, 2010. 2011. Accessed 1 Aug 2012.
  3. 3.
    Imai E, Horio M, Watanabe T, Iseki K, Yamagata K, Hara S, et al. Prevalence of chronic kidney disease in the Japanese general population. Clin Exp Nephrol. 2009;13:621–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Imai E, Horio M, Iseki K, Yamagata K, Watanabe T, Hara S, et al. Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient. Clin Exp Nephrol. 2007;11:156–63.Google Scholar
  5. 5.
    Yamashita T, Yoshida T, Ogawa T, Tsuchiya K, Nitta K. Clinical outcomes in patients with chronic kidney disease: a 5-year retrospective cohort study at a University Hospital in Japan. Clin Exp Nephrol. 2011;15:831–40.CrossRefPubMedGoogle Scholar
  6. 6.
    Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.CrossRefPubMedGoogle Scholar
  7. 7.
    Ninomiya T, Kiyohara Y, Kubo M, Tanizaki Y, Doi Y, Okubo K, et al. Chronic kidney disease and cardiovascular disease in a general Japanese population: the Hisayama Study. Kidney Int. 2005;68:228–36.CrossRefPubMedGoogle Scholar
  8. 8.
    Irie F, Iso H, Sairenchi T, Fukasawa N, Yamagishi K, Ikehara S, et al. The relationships of proteinuria, serum creatinine, glomerular filtration rate with cardiovascular disease mortality in Japanese general population. Kidney Int. 2006;69:1264–71.CrossRefPubMedGoogle Scholar
  9. 9.
    Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent left ventricular hypertrophy in predialysis population: identifying opportunities for intervention. Am J Kidney Dis. 1996;27:347–54.CrossRefPubMedGoogle Scholar
  10. 10.
    Tucker B, Fabbian F, Giles M, Thuraisingham RC, Raine AE, Baker LR. Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure. Nephrol Dial Transplant. 1997;12:724–8.CrossRefPubMedGoogle Scholar
  11. 11.
    McMahon LP, Roger SD, Slimheart Investigators Group. Development, prevention, and potential reversal of left ventricular hyperterophy in chronic kidney disease. J Am Soc Nephrol. 2004;15:1640–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Paoletti E, Bellino D, Cassottana P, Rolla D, Cannella G. Left ventricular hypertrophy in nondiabetic predialysis patients. Am J Kidney Dis. 2005;46:320–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, et al. Chronic Kidney Disease Japan Cohort study: baseline characteristics and factors associated with causative diseases and renal function. Clin Exp Nephrol. 2010;14:558–70.CrossRefPubMedGoogle Scholar
  14. 14.
    Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, et al. Chronic Kidney Disease Japan Cohort (CKD-JAC) study: design and methods. Hypertens Res. 2008;3:1101–7.CrossRefGoogle Scholar
  15. 15.
    Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRefPubMedGoogle Scholar
  16. 16.
    Reichek N, Devereux RB. Left ventricular hypertrophy: relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation. 1981;63:1391–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986;57:450–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Miura K, Nakagawa H, Ohashi Y, Harada A, Taguri M, Kushiro T, et al. Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies. Circulation. 2009;119:1892–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Levin A, Thrompson CR, Ethier J, Carisie EJ, Tobe S, Mendelssohn D, et al. Left ventricular mass index increase in early renal disease: impact of decline in hemoglobin. Am J Kidney Dis. 1999;34:125–34.CrossRefPubMedGoogle Scholar
  20. 20.
    Nardi E, Palermo A, Mule G, Cusimano P, Cotton S, Cerasola G. Left ventricular hypertrophy and geometry in hypertensive patients with chronic kidney disease. J Hypertens. 2009;27:633–41.CrossRefPubMedGoogle Scholar
  21. 21.
    Locatelli F, Bommer J, London GM, Martin-Malo A, Wanner C, Yaqoob M, et al. Cardiovascular disease determinants in chronic renal failure: clinical approach and treatment. Nephrol Dial Transplant. 2001;16:459–68.CrossRefPubMedGoogle Scholar
  22. 22.
    London G. Pathophysiology of cardiovascular damage in the early renal population. Nephrol Dial Transplant. 2001;16(Suppl 2):3–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Nitta K. Pathogenesis and therapeutic implications of cardiorenal syndrome. Clin Exp Nephrol. 2011;15:187–94.CrossRefPubMedGoogle Scholar
  24. 24.
    McCullough PA. Cardiovascular disease in chronic kidney disease from a cardiologist’s perspective. Curr Opin Nephrol Hypertens. 2004;13:591–600.CrossRefPubMedGoogle Scholar
  25. 25.
    McCullough PA, Li S, Jurkovitz CT, Johnson B, Shlipak MG, Obialo CI, et al. Chronic kidney disease, prevalence of premature cardiovascular disease, and relationship to short-term mortality. Am Heart J. 2008;156:277–83.CrossRefPubMedGoogle Scholar
  26. 26.
    Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321:225–36.CrossRefPubMedGoogle Scholar
  27. 27.
    Kotsis V, Stabouli S, Toumanidis S, Tsivqoulis G, Rizos Z, Trakateli C, et al. Obesity and daytime pulse pressure are predictors of left ventricular hypertrophy in true normotensive individuals. J Hypertens. 2010;28:1065–73.CrossRefPubMedGoogle Scholar
  28. 28.
    Guerra F, Mancinelli L, Angelini L, Fortunati M, Rappelli A, Dessi-Fulgheri P, et al. The association of left ventricular hypertrophy with metabolic syndrome is dependent on body mass index in hypertensive overweight or obese patients. PLoS One. 2011;6:e16630.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Verhave JC, Hillege HL, Burgerhof JG, Navis G, de Zeeuw D, de Jong PE, et al. Cardiovascular risk factors are differently associated with urinary albumin excretion in men and women. J Am Soc Nephrol. 2003;14:1330–5.CrossRefPubMedGoogle Scholar
  30. 30.
    Meisinger C, Doring A, KORA Study Group. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. Eur Heart J. 2006;27:1245–50.CrossRefPubMedGoogle Scholar
  31. 31.
    Kurth T, de Jong PE, Cook NR, Buring JE, Ridker PM. Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study. BMJ. 2009;338:b2392.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Muiesan ML, Ambrosioni E, Costa FV, Leonetti G, Pessina AC, Salvetti M, et al. Sex differences in hypertension-related renal and cardiovascular disease in Italy: the I-DEMAND study. J Hypertens. 2012;30:2378–86.CrossRefPubMedGoogle Scholar
  33. 33.
    Covic A, Kothawala P, Nernal M, Robbins S, Chalian A, Goldsmith D. Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol Dial Transplant. 2009;24:1506–23.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2013

Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

Authors and Affiliations

  • Kosaku Nitta
    • 1
    Email author
  • Satoshi Iimuro
    • 2
  • Enyu Imai
    • 3
  • Seiichi Matsuo
    • 3
  • Hirofumi Makino
    • 4
  • Tadao Akizawa
    • 5
  • Tsuyoshi Watanabe
    • 6
  • Yasuo Ohashi
    • 2
  • Akira Hishida
    • 7
  1. 1.Department of Medicine, Kidney CenterTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Department of Biostatistics, School of Public HealthThe University of TokyoTokyoJapan
  3. 3.Department of NephrologyNagoya University Graduate School of MedicineNagoyaJapan
  4. 4.Department of Medicine and Clinical ScienceOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  5. 5.Department of NephrologyShowa UniversityTokyoJapan
  6. 6.Third Department of Internal MedicineFukushima Medical UniversityFukushimaJapan
  7. 7.Yaizu City HospitalShizuokaJapan

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