Association between proteinuria and left ventricular mass index: a cardiac MRI study in patients with chronic kidney disease

McQuarrie, E.P., Patel, R.K., Mark, P.B. , Delles, C. , Connell, J., Dargie, H.J., Steedman, T. and Jardine, A.G. (2011) Association between proteinuria and left ventricular mass index: a cardiac MRI study in patients with chronic kidney disease. Nephrology Dialysis Transplantation, 26(3), pp. 933-938. (doi: 10.1093/ndt/gfq418)

Abstract

Background. Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. We hypothesized that the level of proteinuria would correlate with left ventricular mass, providing a potential link between elevated protein excretion, left ventricular hypertrophy (LVH) and the increased mortality seen in patients with CKD. In order to do this, we assessed the determinants of left ventricular mass, measured using cardiac magnetic resonance (CMR) imaging, in patients with CKD. <p/>Methods. Patients attending the renal clinic with CKD stages 2-4 and diabetic nephropathy (n = 26) and IgA nephropathy (n = 23) were recruited. They underwent detailed demographic, biochemical and vascular phenotyping and CMR imaging. Proteinuria was measured using spot protein: creatinine ratio (PCR). Left ventricular mass index (LVMI) was calculated from short-axis cine imaging using Argus software and adjusted for body surface area. <p/>Results. Log-PCR correlated significantly with LVMI, as did waist circumference, pulse pressure and systolic blood pressure. LVMI was higher in men. When these variables were entered into a linear regression model, log-PCR (P = 0.006) and systolic blood pressure (P < 0.001) independently predicted LVMI. Renal function was not associated with LVMI. <p/>Conclusions. Using volume-independent CMR imaging, we have demonstrated that the level of urinary protein excretion is independently and significantly associated with left ventricular mass in patients with CKD. This relationship was independent of blood pressure. This finding provides a novel link between CKD and increased cardiovascular risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Patel, Dr Rajan and McQuarrie, Dr Emily and Dargie, Professor Henry and Connell, Professor John and Mark, Professor Patrick and Hopkins, Mrs Tracey and Delles, Professor Christian and Jardine, Professor Alan
• Authors: McQuarrie, E.P., Patel, R.K., Mark, P.B., Delles, C., Connell, J., Dargie, H.J., Steedman, T., and Jardine, A.G.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Nephrology Dialysis Transplantation
• Publisher: Oxford University Press
• ISSN: 0931-0509
• ISSN (Online): 1460-2385
• Published Online: 12 July 2010