Risk factors and prognostic analysis of mitral regurgitation in patients with chronic kidney disease
10.3760/cma.j.cn441217-20240208-00212
- VernacularTitle:慢性肾脏病患者二尖瓣反流的危险因素及预后分析
- Author:
Ran AN
1
;
Wen LI
1
;
Zheng YAO
1
;
Leiyun WU
1
;
Wenjing FU
1
;
Na LIN
1
;
Aihua ZHANG
1
Author Information
1. 首都医科大学宣武医院肾内科，北京 100053
- Publication Type:Journal Article
- Keywords:
Mitral valve insufficiency;
Renal insufficiency, chronic;
Risk factors;
Prognosis;
Mitral regurgitation
- From:
Chinese Journal of Nephrology
2024;40(12):931-939
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors and prognosis of mitral regurgitation (MR) in patients with chronic kidney disease (CKD).Methods:Clinical data were collected from CKD patients who were hospitalized at the Department of Nephrology, Xuanwu Hospital, Capital Medical University, from January 1, 2018, to December 31, 2019, and underwent echocardiography. Patients were followed up until November 1, 2021, with the endpoint being all-cause mortality.Logistic regression was used to analyze the risk factors of MR in CKD patients. Kaplan-Meier survival analysis was performed to plot the survival curve, with the Log-rank test comparing the survival rate. Multivariate Cox regression analysis was used to identify the risk factors of death in CKD patients.Results:It was a retrospective single-center study. A total of 555 CKD patients were included, with 262 patients developing MR. Of whom, 212 patients had mild MR (80.9%), 44 patients had modreate MR (16.8%), 6 patients had severe MR (2.3%). The prevalence of MR among patients with CKD stages 1 to 5 was 21.9%, 33.0%, 45.9%, 51.9%, and 64.6%, and the prevalence of moderate to severe MR was 0, 5.6%, 7.4%, 10.1%, and 15.9%. Multivariate logistic regression analysis revealed that male sex ( OR=1.579, 95% CI 1.008-2.476, P=0.046), presence of chronic heart disease ( OR=2.263, 95% CI 1.398-3.662, P=0.001), CKD stage 4-5 (with CKD stage 1-3 as reference, OR=1.744, 95% CI 1.007-3.019, P=0.047), and decreasing hemoglobin levels ( OR=0.985, 95% CI 0.975-0.996, P=0.006) were the associated factors for MR in CKD patients. Kaplan-Meier survival analysis indicated higher all-cause mortality (Log-rank, χ2=8.094, P=0.004) in the MR group compared to the non-MR group. Multivariate Cox regression analysis showed that increasing age ( HR=1.072, 95% CI 1.042-1.104, P<0.001), elevating blood phosphorus ( HR=2.782, 95% CI 1.122-6.895, P=0.027), MR ( HR=1.962, 95% CI 1.002-3.839, P=0.049) and decreasing albumin ( HR=0.927, 95% CI 0.886-0.970, P=0.001) were independent associated factors for all-cause death in CKD patients. Conclusions:The overall prevalence of MR and the prevalence of moderate to severe MR are increasing with the progression of CKD. Male sex, presence of chronic heart disease, CKD stage 4-5 and decreasing hemoglobin levels are risk factors for MR in CKD patients. MR is an independent risk factor for all-cause mortality in CKD patients.
