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Early impact of albuminuria on cardiac function in patients with chronic kidney disease: a prospective study

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Abstract

Cardiovascular disease (CVD) is the leading cause of end-stage mortality in chronic kidney disease (CKD) patients. However, CVD and CKD are inextricably linked, as microalbuminuria is an independent risk factor for CVD. Herein, we investigated changes in cardiac function and its risk factors in CKD patients who had different urine albumin-to-creatinine ratios (UACRs) and estimated glomerular filtration rates (eGFRs). We prospectively enrolled 182 CKD patients, classified into three groups based on UACRs and eGFRs. Fifty healthy volunteers were included as controls. Changes in clinical and echocardiographic parameters were assessed in each group, and factors independently associated with strain parameters were further analyzed. Compared with those in the control group, the albuminuria but unimpaired renal function (ALB-CKD G1-2), albuminuria and impaired renal function (ALB-CKD G3), and normoalbuminuric CKD (NACKD) groups had decreased left ventricular (LV), right ventricular (RV), and left atrial (LA) strains, the LA contractile strain being the only statistically comparable parameter. Stepwise multiple linear regression analysis revealed varying factors independently correlating with the LV global longitudinal strain. The LA reservoir and conduit strains independently correlated with LV diastolic function in stage 3 CKD associated with comorbid albuminuria or normoalbuminuria. LV function was a partial determinant of LA and RV function in the ALB-CKD G3 group, whereas ventricular and atrial function were independent of each other in the ALB-CKD G1-2 and NACKD groups. Clinical intervention should focus on specific factors affecting cardiac function in patients to reduce the risk of CVD-related death.

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Data availability

The datasets generated and/or analyzed during the current study are not publicly available due to privacy or ethical restrictions but are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank all the clinical staff for their support of this study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Medical Ultrasonics, First Affiliated Hospital with Jinzhou Medical University (Liaoning Province Hospital), No. 2, Section 5, Renmin Street, Guta District, Jinzhou, China

    Yiming Li & Chuan Tian

  2. Department of Nephrology, First Affiliated Hospital with Jinzhou Medical University, Jinzhou, China

    Yongzhan Liu & Lili Gao

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  1. Yiming Li
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  2. Yongzhan Liu
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Contributions

Y.L drafting the article C.T the conception and design of the study Y. L, Y. L, and L.G： Acquisition of data, or analysis and interpretation of dataY. Li drafting the article C. T revising it critically for important intellectual content, and final approval of the version to be submitted.

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Correspondence to Chuan Tian.

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Li, Y., Liu, Y., Gao, L. et al. Early impact of albuminuria on cardiac function in patients with chronic kidney disease: a prospective study. Int J Cardiovasc Imaging 40, 873–885 (2024). https://doi.org/10.1007/s10554-024-03056-4

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  • DOI: https://doi.org/10.1007/s10554-024-03056-4

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