scholarly journals FGF23 and Left Ventricular Hypertrophy in Children with CKD

2017 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Mark M. Mitsnefes ◽  
Aisha Betoko ◽  
Michael F. Schneider ◽  
Isidro B. Salusky ◽  
Myles Selig Wolf ◽  
...  

Background and ObjectivesHigh plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.Design, setting, participants, & measurementsWe performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH (LVMI ≥95th percentile), adjusted for demographics, body mass index, eGFR, and CKD-specific factors. We also examined the relationship between FGF23 and LVH by eGFR level.ResultsMedian age was 12 years (interquartile range, 8–15) and eGFR was 50 ml/min per 1.73 m2 (interquartile range, 38–64). Overall prevalence of LVH was 11%. After adjustment for demographics and body mass index, the odds of having LVH was higher by 2.53 (95% confidence interval, 1.28 to 4.97; P<0.01) in participants with FGF23 concentrations ≥170 RU/ml compared with those with FGF23<100 RU/ml, but this association was attenuated after full adjustment. Among participants with eGFR≥45 ml/min per 1.73 m2, the prevalence of LVH was 5.4%, 11.2%, and 15.3% for those with FGF23 <100 RU/ml, 100–169 RU/ml, and ≥170 RU/ml, respectively (Ptrend=0.01). When eGFR was ≥45 ml/min per 1.73 m2, higher FGF23 concentrations were independently associated with LVH (fully adjusted odds ratio, 3.08 in the highest versus lowest FGF23 category; 95% confidence interval, 1.02 to 9.24; P<0.05; fully adjusted odds ratio, 2.02 per doubling of FGF23; 95% confidence interval, 1.29 to 3.17; P<0.01). By contrast, in participants with eGFR<45 ml/min per 1.73 m2, FGF23 did not associate with LVH.ConclusionsPlasma FGF23 concentration ≥170 RU/ml is an independent predictor of LVH in children with eGFR≥45 ml/min per 1.73 m2.

2012 ◽  
Vol 155 ◽  
pp. S2-S3
Author(s):  
A.B. Kepuska ◽  
A. Batalli ◽  
M. Zejnullahu ◽  
M. Shala ◽  
M. Azemi ◽  
...  

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S695-700
Author(s):  
Fauzia Nazir ◽  
Tahir Iqbal ◽  
Javeria Kamran ◽  
Tariq Hussain Khattak ◽  
Anum Fatima ◽  
...  

Objective: To determine the association between cardiovascular risk factors and the abnormalities of left ventricular geometric abnormalities. Study Design: Prospective cross-sectional, single centered study. Place and Duration of Study: Armed Forces Institute of Cardiology, Rawalpindi, from Jun 2018 to Dec 2018. Methodology: This study permission was sought from hospital ethics committee. Written informed consent was taken from participants of study. Particulars of all the patients who meet the inclusion were included i.e., 351 hypertensive. Results: Left ventricular geometric abnormalities were detected in 321 subjects (91%), wherein concentric non dilated left ventricular hypertrophy is the most common left ventricular geometric abnormality (39%). Elevated systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular remodeling, whereas body mass index and chronic kidney disease were inversely associated with concentric abnormalities. systolic blood pressure and diabetes mellitus, chronic kidney disease, large WC were positively associated with eccentric dilated left ventricular hypertrophy, while body mass index, duration of hypertension, MS were inversely associated with eccentric dilated left ventricular hypertrophy. Elevated systolic blood pressure was the strongest risk factor for eccentric dilated left ventricular hypertrophy. Large WC, systolic blood pressure and diabetes mellitus were positively associated with concentric left ventricular hypertrophy, whereas body mass index was negatively associated with concentric left ventricular hypertrophy. Conclusion: Appropriate risk factor management and compliance can prevent left ventricular geometric abnormalities hence poorer outcomes in our population


1996 ◽  
Vol 7 (12) ◽  
pp. 2550-2558
Author(s):  
R Pontremoli ◽  
A Sofia ◽  
A Tirotta ◽  
M Ravera ◽  
C Nicolella ◽  
...  

The activity of the renin-angiotensin-aldosterone system is thought to play a significant role in the development of target organ damage in essential hypertension. An insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene has recently been associated with increased risk for left ventricular hypertrophy and coronary heart disease in the general population. The D allele is associated with higher levels of circulating ACE and therefore may predispose to cardiovascular damage. The study presented here was performed to investigate the association between the ACE genotype, microalbuminuria, retinopathy, and left ventricular hypertrophy in 106 patients with essential hypertension. ACE gene polymorphism was determined by polymerase chain reaction technique. Microalbuminuria was evaluated as albumin-to-creatinine ratio (A/C) in three nonconsecutive first morning urine samples (negative urine culture) after a 4-wk washout period. Microalbuminuria was defined as A/C between 2.38 to 19 (men) and 2.96 to 20 (women). Hypertensive retinopathy was evaluated by direct funduscopic examination (keith-Wagener-Barker classification) and left ventricular hypertrophy by M-B mode echocardiography. The distribution of the DD, ID, and II genotypes was 27, 50, and 23%, respectively. The prevalence of microalbuminuria, retinopathy, and left ventricular hypertrophy was 19, 74, and 72% respectively. There were no differences among the three genotypes for age, known duration of disease, body mass index, blood pressure, serum glucose, uric acid, and lipid profile. DD and ID genotypes were significantly associated with the presence of microalbuminuria (odds ratio, 8.51; 95% confidence interval, 1.07 to 67.85; P = 0.019), retinopathy (odds ratio, 5.19; 95% confidence interval, 1.71 to 15.75; P = 0.005) and left ventricular hypertrophy (odds ratio, 5.22; 95% confidence interval, 1.52 to 17.94; P = 0.016). Furthermore, patients with DD and ID genotypes showed higher levels of A/C (3.6 +/- 0.9, DD; 2.6 +/- 0.7, ID; 0.9 +/- 0.2 mg/mmol, II; P = 0.0015 by analysis of variance) and increased left ventricular mass index (152 +/- 4.7, DD + ID versus 133 +/- 5.7 g/m2, II; P = 0.01) compared with II patients. The D allele was significantly more frequent in patients with microalbuminuria (odds ratio, 2.59; 95% confidence interval, 1.24 to 5.41; P = 0.013) and in those with retinopathy (odds ratio, 2.44; 95% confidence interval, 1.21 to 4.90; P = 0.015). Multiple regression analyses performed among the entire cohort of patients demonstrated that ACE genotype significantly and independently influences the presence of retinopathy, left ventricular hypertrophy, and microalbuminuria. In conclusion, the D allele of the ACE gene is associated with microalbuminuria as well as with retinopathy and left ventricular hypertrophy, and seems to be an independent risk factor for target organ damage in essential hypertension.


2010 ◽  
Vol 19 (6) ◽  
pp. 337-343 ◽  
Author(s):  
Cesare Cuspidi ◽  
Valentina Giudici ◽  
Laura Lonati ◽  
Carla Sala ◽  
Cristiana Valerio ◽  
...  

2019 ◽  
Vol 8 (2) ◽  
pp. 345-356 ◽  
Author(s):  
Theodora W. Elffers ◽  
Stella Trompet ◽  
Renée de Mutsert ◽  
Arie C. Maan ◽  
Hildo J. Lamb ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document