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- Publisher Website: 10.1093/ndt/gfs588
- Scopus: eid_2-s2.0-84884521753
- PMID: 23314317
- WOS: WOS:000324493400020
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Article: Plasma sodium and subclinical left atrial enlargement in chronic kidney disease
Title | Plasma sodium and subclinical left atrial enlargement in chronic kidney disease |
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Authors | |
Keywords | Chronic kidney disease |
Issue Date | 2013 |
Citation | Nephrology Dialysis Transplantation, 2013, v. 28, n. 9, p. 2319-2328 How to Cite? |
Abstract | Background. Left atrial enlargement (LAE) reflects diastolic dysfunction and predicts mortality in end-stage renal disease patients. However, little is known of its prevalence and factors associated with subclinical LAE in earlier stages of chronic kidney disease (CKD). Methods. We conducted a prospective, cross-sectional study in 261 Stage 3-5 non-dialysis CKD patients without symptomatic cardiovascular disease with two-dimensional echocardiography performed to estimate left atrial volume index and other cardiac parameters. Results. One hundred and nine (41.8%) patients had LAE. Mild and moderate/severe LAEs were observed in 22.9 and 41.3% of patients with left ventricular (LV) hypertrophy (n = 109) versus 13.2 and 12.5% of patients with no LV hypertrophy (n = 152), respectively (P < 0.001). On univariate analysis, plasma sodium concentration showed a significant association with LAE [odds ratio (OR) 1.22, 95% confidence interval (95% CI) 1.09-1.37; P = 0.001]. In the stepwise multiple logistic regression, plasma sodium concentration emerged as one of the most significant factors associated with LAE (adjusted OR 1.29, 95% CI 1.14-1.47; P < 0.001]. Its significance was well maintained (adjusted OR 1.23, 95% CI 1.07-1.43; P = 0.005) when including LV mass and volume index and N-terminal pro-brain natriuretic peptide in the model, while blood haemoglobin and systolic blood pressure were displaced. Conclusions. This study for the first time alerted to a very high prevalence of subclinical LAE and reported a strong novel, independent relationship between plasma sodium concentration and subclinical LAE in Stage 3-5 CKD patients. Longitudinal studies are needed to establish causality between high plasma sodium concentration and LAE and their usefulness as therapeutic targets in CKD. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. |
Persistent Identifier | http://hdl.handle.net/10722/228476 |
ISSN | 2023 Impact Factor: 4.8 2023 SCImago Journal Rankings: 1.414 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wang, Angela Yee Moon | - |
dc.contributor.author | Lu, Ye | - |
dc.contributor.author | Cheung, Sharon | - |
dc.contributor.author | Chan, Iris Hiu Shuen | - |
dc.contributor.author | Lam, Christopher Wai Kei | - |
dc.date.accessioned | 2016-08-13T08:02:30Z | - |
dc.date.available | 2016-08-13T08:02:30Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | Nephrology Dialysis Transplantation, 2013, v. 28, n. 9, p. 2319-2328 | - |
dc.identifier.issn | 0931-0509 | - |
dc.identifier.uri | http://hdl.handle.net/10722/228476 | - |
dc.description.abstract | Background. Left atrial enlargement (LAE) reflects diastolic dysfunction and predicts mortality in end-stage renal disease patients. However, little is known of its prevalence and factors associated with subclinical LAE in earlier stages of chronic kidney disease (CKD). Methods. We conducted a prospective, cross-sectional study in 261 Stage 3-5 non-dialysis CKD patients without symptomatic cardiovascular disease with two-dimensional echocardiography performed to estimate left atrial volume index and other cardiac parameters. Results. One hundred and nine (41.8%) patients had LAE. Mild and moderate/severe LAEs were observed in 22.9 and 41.3% of patients with left ventricular (LV) hypertrophy (n = 109) versus 13.2 and 12.5% of patients with no LV hypertrophy (n = 152), respectively (P < 0.001). On univariate analysis, plasma sodium concentration showed a significant association with LAE [odds ratio (OR) 1.22, 95% confidence interval (95% CI) 1.09-1.37; P = 0.001]. In the stepwise multiple logistic regression, plasma sodium concentration emerged as one of the most significant factors associated with LAE (adjusted OR 1.29, 95% CI 1.14-1.47; P < 0.001]. Its significance was well maintained (adjusted OR 1.23, 95% CI 1.07-1.43; P = 0.005) when including LV mass and volume index and N-terminal pro-brain natriuretic peptide in the model, while blood haemoglobin and systolic blood pressure were displaced. Conclusions. This study for the first time alerted to a very high prevalence of subclinical LAE and reported a strong novel, independent relationship between plasma sodium concentration and subclinical LAE in Stage 3-5 CKD patients. Longitudinal studies are needed to establish causality between high plasma sodium concentration and LAE and their usefulness as therapeutic targets in CKD. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. | - |
dc.language | eng | - |
dc.relation.ispartof | Nephrology Dialysis Transplantation | - |
dc.subject | Chronic kidney disease | - |
dc.title | Plasma sodium and subclinical left atrial enlargement in chronic kidney disease | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1093/ndt/gfs588 | - |
dc.identifier.pmid | 23314317 | - |
dc.identifier.scopus | eid_2-s2.0-84884521753 | - |
dc.identifier.volume | 28 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 2319 | - |
dc.identifier.epage | 2328 | - |
dc.identifier.eissn | 1460-2385 | - |
dc.identifier.isi | WOS:000324493400020 | - |
dc.identifier.issnl | 0931-0509 | - |