Abstract 12852: Electrocardiographic Left Ventricular Hypertrophy and ST-segment Abnormality and Risk of Development and Progression of Chronic Kidney Disease
Background: There is a close relationship between chronic kidney disease (CKD) and cardiovascular disease. However, the association of electrocardiographic abnormalities with the risk of CKD is unknown.
Methods: This is a prospective observational cohort study based on an annual health check-up program in the general population. We studied the effects of ECG abnormalities on development and progression of CKD. Renal dysfunction was defined as eGFR <60 mL/min/1.73m2.
Results: Risk of development of CKD In 223,132 subjects (age, 61±12 years) without baseline CKD, 14,507 subjects (6.5%) developed proteinuria during a follow-up of 5.9±2.3 years. In multivariate models, ST-segment abnormality, left ventricular hypertrophy, left bundle branch block, and the presence of premature beat(s) during 10 second recording were associated with the increased risk of developing proteinuria (Table). During a follow-up, 8517 subjects (3.8%) developed renal dysfunction. ST-segment abnormality, left ventricular hypertrophy, first-degree atrioventricular block, and premature beat(s) were associated with the increased risk of developing renal dysfunction (Table). To exclude the effects of structural heart disease, the multivariate analyses were repeated after exclusion of subjects who had hypertension and/or heart disease. In 149,568 subjects, ST-segment abnormality and left ventricular hypertrophy increased the risk of developing proteinuria and that of developing renal dysfunction. Risk of progression of CKD We also studied the effects of ECG abnormalities on progression of CKD in 4242 subjects with baseline renal dysfunction. During a follow-up, eGFR declined ≥10 mL/min/1.73m2 in 850 subjects (20%). Left ventricular hypertrophy (HR, 1.82; 95% CI, 1.09-3.03) and ST-segment abnormality (HR, 1.38; 95% CI, 1.13-1.69) were associated with progression of CKD.
Conclusions: We identified electrocardiographic risk factors for development and progression of CKD.
- © 2011 by American Heart Association, Inc.