Body Mass Index, Left Ventricular Mass Index and Cardiovascular Events in Chronic Kidney Disease

Abstract

BackgroundObesity and left ventricular hypertrophy are prevalent in chronic kidney disease (CKD), but the association of body mass index (BMI) and left ventricular mass index (LVMI) with cardiovascular outcomes in patients with CKD is unclear. This study was designed to assess whether the combination of BMI and LVMI is independently associated with cardiovascular events in patients with CKD stages 3-5. MethodsFrom the outpatient department, 523 patients with CKD who received echocardiographic examination were enrolled. The patients under study were classified into 4 groups according to sex-specific median BMIs and LVMIs. Cardiovascular events were defined as cardiovascular death, hospitalization for unstable angina, nonfatal myocardial infarction, sustained ventricular arrhythmia, hospitalization for congestive heart failure, transient ischemia attack and stroke. The relative cardiovascular event risk was analyzed using Cox-regression methods. ResultsThe patients were stratified into 4 groups according to sex-specific median BMIs (men: 25.2kg/m2; women: 24.9kg/m2) and LVMIs (men: 140.1g/m2; women: 131.6g/m2). A combination of low BMI and high LVMI (versus the combination of high BMI and low LVMI) was significantly associated with cardiovascular events in an unadjusted model (hazard ratio [HR] = 3.178; 95% confidence interval [CI]: 1.645-6.140; P < 0.001) and in a multivariable model after adjustment for demographic, clinical and biochemical characteristics and medications (HR = 3.553; 95% CI: 1.494-8.450; P = 0.004). ConclusionsThe findings showed that the combination of low BMI and high LVMI was associated with adverse cardiovascular events in patients with CKD stages 3–5.