抄録
Objective: We performed this study to assess whether chronic kidney disease (CKD) is associated with major heart abnormalities detected in health examinations.
Methods: Subjects were 9,505 Japanese male adults without a history of renal failure, coronary heart disease (CHD), atrial fibrillation (AF), cardiac hypertrophy, cardiomyopathy, or heart failure. We obtained results of worksite health examinations during 2009-2010. CKD was diagnosed by either dipstick proteinuria ≥1+ or reduced estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. The participants were classified into 4 groups based on proteinuria and eGFR as follows: (i) no CKD (n=8,861), (ii) CKD (proteinuria+/reduced eGFR-) (n=162), (iii) CKD (proteinuria-/reduced eGFR+) (n=432), and (iv) CKD (proteinuria+/reduced eGFR+) (n=50). Heart abnormalities were defined as CHD, AF, left ventricular hypertrophy (LVH), and cardiomegaly using electrocardiography (ECG) and chest X-rays. We analyzed relationships between CKD and these heart abnormalities in consideration of traditional cardiovascular disease (CVD) risk factors.
Results: CKD was significantly associated with the prevalence of ECG-defined CHD, AF and LVH except for radiographic cardiomegaly. The number of traditional CVD risk factors increased with CKD development (p<0.001). Furthermore, the prevalence of CHD increased gradually according to the presence of proteinuria, reduced eGFR and a larger number of other combined CVD risk factors. The multivariate adjusted odds ratios (95% CI) for proteinuria and reduced eGFR were 1.90 (0.90-4.02, p=0.091) and 1.83 (1.03-3.28, p=0.041) for ECG-defined CHD, respectively.
Conclusion: CKD may be a determinant of major heart abnormalities that could serve as an early predictor of CVD-related mortality.
