Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease
Left ventricular hypertrophy (LVH) and anemia are highly prevalent in moderate chronic kidney disease (CKD). Because anemia may potentiate the adverse effects of LVH on cardiovascular outcomes, the effect of both anemia and LVH on outcomes in CKD was examined. Data from four community-based longitud...
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| Veröffentlicht in: | Journal of the American Society of Nephrology 2005-06, Vol.16 (6), p.1803-1810 |
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| container_title | Journal of the American Society of Nephrology |
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| creator | WEINER, Daniel E TIGHIOUART, Hocine VLAGOPOULOS, Panagiotis T GRIFFITH, John L SALEM, Deeb N LEVEY, Andrew S SARNAK, Mark J |
| description | Left ventricular hypertrophy (LVH) and anemia are highly prevalent in moderate chronic kidney disease (CKD). Because anemia may potentiate the adverse effects of LVH on cardiovascular outcomes, the effect of both anemia and LVH on outcomes in CKD was examined. Data from four community-based longitudinal studies were pooled: Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Heart Study, and Framingham Offspring Study. Serum creatinine levels were calibrated indirectly across studies, and GFR was estimated using the Modification of Diet in Renal Disease equation. CKD was defined as GFR between 15 and 60 ml/min per 1.73 m(2). LVH was based on electrocardiogram criteria. Anemia was defined as hematocrit |
| doi_str_mv | 10.1681/ASN.2004070597 |
| format | Article |
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Because anemia may potentiate the adverse effects of LVH on cardiovascular outcomes, the effect of both anemia and LVH on outcomes in CKD was examined. Data from four community-based longitudinal studies were pooled: Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Heart Study, and Framingham Offspring Study. Serum creatinine levels were calibrated indirectly across studies, and GFR was estimated using the Modification of Diet in Renal Disease equation. CKD was defined as GFR between 15 and 60 ml/min per 1.73 m(2). LVH was based on electrocardiogram criteria. Anemia was defined as hematocrit <36% in women and 39% in men. The primary outcome was a composite of myocardial infarction, stroke, and death; a secondary cardiac outcome included only myocardial infarction and fatal coronary heart disease. Among 2423 patients with CKD, 96% had electrocardiogram and anemia data. Median follow-up was 102 mo. In adjusted analysis, LVH was associated with increased risk for composite and cardiac outcomes (hazard ratio [HR], 1.67 [95% confidence interval (CI), 1.34 to 2.07] and 1.62 [95% CI, 1.18 to 2.24], respectively), whereas anemia was associated with increased risk for the only composite outcome (HR, 1.51 [95% CI, 1.27 to 1.81]). The combination of anemia and LVH was associated with an increased risk for both study outcomes compared with individuals with neither risk factor (HR, 4.15 [95% CI, 2.62 to 6.56] and 3.92 [95% CI, 2.05 to 7.48]; P = 0.02 and 0.01 for interaction term, respectively). The combination of anemia and LVH in CKD identifies a high-risk population.</description><identifier>ISSN: 1046-6673</identifier><identifier>EISSN: 1533-3450</identifier><identifier>DOI: 10.1681/ASN.2004070597</identifier><identifier>PMID: 15857925</identifier><identifier>CODEN: JASNEU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Aged ; Anemia - complications ; Anemias. Hemoglobinopathies ; Biological and medical sciences ; Cardiovascular Diseases - complications ; Chronic Disease ; Diseases of red blood cells ; Female ; Hematologic and hematopoietic diseases ; Humans ; Hypertrophy, Left Ventricular - complications ; Kidney Diseases - complications ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Outcome Assessment (Health Care) ; Renal failure</subject><ispartof>Journal of the American Society of Nephrology, 2005-06, Vol.16 (6), p.1803-1810</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-1f27b3afb0faad4a04101db4836d06be482734dcd88717a3894c1cd78494a1b53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16831317$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15857925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WEINER, Daniel E</creatorcontrib><creatorcontrib>TIGHIOUART, Hocine</creatorcontrib><creatorcontrib>VLAGOPOULOS, Panagiotis T</creatorcontrib><creatorcontrib>GRIFFITH, John L</creatorcontrib><creatorcontrib>SALEM, Deeb N</creatorcontrib><creatorcontrib>LEVEY, Andrew S</creatorcontrib><creatorcontrib>SARNAK, Mark J</creatorcontrib><title>Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease</title><title>Journal of the American Society of Nephrology</title><addtitle>J Am Soc Nephrol</addtitle><description>Left ventricular hypertrophy (LVH) and anemia are highly prevalent in moderate chronic kidney disease (CKD). Because anemia may potentiate the adverse effects of LVH on cardiovascular outcomes, the effect of both anemia and LVH on outcomes in CKD was examined. Data from four community-based longitudinal studies were pooled: Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Heart Study, and Framingham Offspring Study. Serum creatinine levels were calibrated indirectly across studies, and GFR was estimated using the Modification of Diet in Renal Disease equation. CKD was defined as GFR between 15 and 60 ml/min per 1.73 m(2). LVH was based on electrocardiogram criteria. Anemia was defined as hematocrit <36% in women and 39% in men. The primary outcome was a composite of myocardial infarction, stroke, and death; a secondary cardiac outcome included only myocardial infarction and fatal coronary heart disease. Among 2423 patients with CKD, 96% had electrocardiogram and anemia data. Median follow-up was 102 mo. In adjusted analysis, LVH was associated with increased risk for composite and cardiac outcomes (hazard ratio [HR], 1.67 [95% confidence interval (CI), 1.34 to 2.07] and 1.62 [95% CI, 1.18 to 2.24], respectively), whereas anemia was associated with increased risk for the only composite outcome (HR, 1.51 [95% CI, 1.27 to 1.81]). The combination of anemia and LVH was associated with an increased risk for both study outcomes compared with individuals with neither risk factor (HR, 4.15 [95% CI, 2.62 to 6.56] and 3.92 [95% CI, 2.05 to 7.48]; P = 0.02 and 0.01 for interaction term, respectively). The combination of anemia and LVH in CKD identifies a high-risk population.</description><subject>Aged</subject><subject>Anemia - complications</subject><subject>Anemias. Hemoglobinopathies</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular Diseases - complications</subject><subject>Chronic Disease</subject><subject>Diseases of red blood cells</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Hypertrophy, Left Ventricular - complications</subject><subject>Kidney Diseases - complications</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Outcome Assessment (Health Care)</subject><subject>Renal failure</subject><issn>1046-6673</issn><issn>1533-3450</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtOwzAQRS0Eory2LJE3sEuxY8d2lxUqD6mCBbCOJn6ohjQJtgPq32PUoq5mpDn3SnMQuqRkSoWit_PX52lJCCeSVDN5gE5oxVjBeEUO8064KISQbIJOY_wghFallMdoQitVyVlZnaC0cM7qFHHvMHR27SEPg1vrEv62XQpejy0EvNoMNqTQD6sN7jusIRjff0PcXo2PFqLFvsMDJJ9zEf_4tMJ6FfrOa_zpTWc3_9w5OnLQRnuxm2fo_X7xdvdYLF8enu7my0JzolJBXSkbBq4hDsBwIJwSahqumDBENJarUjJutFFKUglMzbim2kjFZxxoU7EzdLPtHUL_NdqY6rWP2rZt_rQfYy2kEkpwksHpFtShjzFYVw_BryFsakrqP8919lzvPefA1a55bNbW7PGd2Axc74DsCFoXoNM-7jmhGGVUsl9eX4dW</recordid><startdate>20050601</startdate><enddate>20050601</enddate><creator>WEINER, Daniel E</creator><creator>TIGHIOUART, Hocine</creator><creator>VLAGOPOULOS, Panagiotis T</creator><creator>GRIFFITH, John L</creator><creator>SALEM, Deeb N</creator><creator>LEVEY, Andrew S</creator><creator>SARNAK, Mark J</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050601</creationdate><title>Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease</title><author>WEINER, Daniel E ; TIGHIOUART, Hocine ; VLAGOPOULOS, Panagiotis T ; GRIFFITH, John L ; SALEM, Deeb N ; LEVEY, Andrew S ; SARNAK, Mark J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-1f27b3afb0faad4a04101db4836d06be482734dcd88717a3894c1cd78494a1b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Anemia - complications</topic><topic>Anemias. Hemoglobinopathies</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular Diseases - complications</topic><topic>Chronic Disease</topic><topic>Diseases of red blood cells</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Hypertrophy, Left Ventricular - complications</topic><topic>Kidney Diseases - complications</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Outcome Assessment (Health Care)</topic><topic>Renal failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WEINER, Daniel E</creatorcontrib><creatorcontrib>TIGHIOUART, Hocine</creatorcontrib><creatorcontrib>VLAGOPOULOS, Panagiotis T</creatorcontrib><creatorcontrib>GRIFFITH, John L</creatorcontrib><creatorcontrib>SALEM, Deeb N</creatorcontrib><creatorcontrib>LEVEY, Andrew S</creatorcontrib><creatorcontrib>SARNAK, Mark J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WEINER, Daniel E</au><au>TIGHIOUART, Hocine</au><au>VLAGOPOULOS, Panagiotis T</au><au>GRIFFITH, John L</au><au>SALEM, Deeb N</au><au>LEVEY, Andrew S</au><au>SARNAK, Mark J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease</atitle><jtitle>Journal of the American Society of Nephrology</jtitle><addtitle>J Am Soc Nephrol</addtitle><date>2005-06-01</date><risdate>2005</risdate><volume>16</volume><issue>6</issue><spage>1803</spage><epage>1810</epage><pages>1803-1810</pages><issn>1046-6673</issn><eissn>1533-3450</eissn><coden>JASNEU</coden><abstract>Left ventricular hypertrophy (LVH) and anemia are highly prevalent in moderate chronic kidney disease (CKD). Because anemia may potentiate the adverse effects of LVH on cardiovascular outcomes, the effect of both anemia and LVH on outcomes in CKD was examined. Data from four community-based longitudinal studies were pooled: Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Heart Study, and Framingham Offspring Study. Serum creatinine levels were calibrated indirectly across studies, and GFR was estimated using the Modification of Diet in Renal Disease equation. CKD was defined as GFR between 15 and 60 ml/min per 1.73 m(2). LVH was based on electrocardiogram criteria. Anemia was defined as hematocrit <36% in women and 39% in men. The primary outcome was a composite of myocardial infarction, stroke, and death; a secondary cardiac outcome included only myocardial infarction and fatal coronary heart disease. Among 2423 patients with CKD, 96% had electrocardiogram and anemia data. Median follow-up was 102 mo. In adjusted analysis, LVH was associated with increased risk for composite and cardiac outcomes (hazard ratio [HR], 1.67 [95% confidence interval (CI), 1.34 to 2.07] and 1.62 [95% CI, 1.18 to 2.24], respectively), whereas anemia was associated with increased risk for the only composite outcome (HR, 1.51 [95% CI, 1.27 to 1.81]). The combination of anemia and LVH was associated with an increased risk for both study outcomes compared with individuals with neither risk factor (HR, 4.15 [95% CI, 2.62 to 6.56] and 3.92 [95% CI, 2.05 to 7.48]; P = 0.02 and 0.01 for interaction term, respectively). The combination of anemia and LVH in CKD identifies a high-risk population.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>15857925</pmid><doi>10.1681/ASN.2004070597</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anemia - complications Anemias. Hemoglobinopathies Biological and medical sciences Cardiovascular Diseases - complications Chronic Disease Diseases of red blood cells Female Hematologic and hematopoietic diseases Humans Hypertrophy, Left Ventricular - complications Kidney Diseases - complications Longitudinal Studies Male Medical sciences Middle Aged Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Outcome Assessment (Health Care) Renal failure |
| title | Effects of anemia and left ventricular hypertrophy on cardiovascular disease in patients with chronic kidney disease |
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