U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism

Author:

Liao Min-Tsun,Liao Che-Wei,Tsai Cheng-Hsuan,Chang Yi-Yao,Chen Zheng-Wei,Pan Chien-Ting,Lin Lung-Chun,Wu Vin-Cent,Kuo Shu-Fen,Wu Xue-Ming,Hung Chi-ShengORCID,Lin Yen-Hung

Abstract

Estimated glomerular filtration rate (eGFR) is an important topic in patients with primary aldosteronism (PA). However, the relationship between left ventricular structure and eGFR is unclear. We conducted a prospective, observational, and cross-sectional study to analyze 168 patients with PA and 168 propensity score-matched patients with essential hypertension (EH) as the control group, matched by age, gender, and systolic blood pressure. In the patients with PA, the eGFR was not correlated with left ventricular mass index (LVMI; r=−0.065, p=0.404), while in the patients with EH, the eGFR was negatively correlated with LVMI (r=−0.309, p<0.001). To test whether eGFR had a non-linear relationship with LVMI among the patients with PA, we stratified the patients with PA according to the tertile of eGFR (low, medium, and high tertile). The medium tertile of patients had a significantly lower LVMI than those in the other two tertiles (LVMI: 143.5±41.6, 120.5±40.5, and 133.1±34.3 g/m2, from the lowest to highest tertile of eGFR; analysis of covariance p=0.032). The medium tertile of eGFR is associated with lowest LVMI. Patients with PA with high and low eGFR were associated with higher LVMI. The findings implied that the reasons for an increased LVMI in patients with PA may be different to those in patients with EH.

Funder

Ta-Tung Kidney Foundation, National Taiwan University Hospital

Ministry of Science and Technology, Taiwan

Department of Health, Executive Yuan, R.O.C.

Publisher

BMJ

Subject

General Biochemistry, Genetics and Molecular Biology,General Medicine

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