J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 13, Number 2, February 2021, pages 121-129

The Association of Glomerular Filtration Rate With Echocardiographic Parameters in Chronic Kidney Disease

Figure 1. APV in a patient with stage V CKD (APV = 38.2 cm/s) (a) and in a patient with stage III (APV = 57.3 cm/s) (b). APV: aortic propagation velocity; CKD: chronic kidney disease.

Figure 2. Measurement of EFT in a patient with stage V (a) and a patient with stage I (b). EFT is perpendicular to the right ventricular free wall (arrow). Ao: aort; LV: left ventricle; RV: right ventricle; EFT: epicardial fat thickness.

Figure 3. Aortic propagation velocity (a), epicardial fat thickness (b) and carotid intima-media thickness (c) values in chronic kidney disease stages.

Figure 4. Correlation analysis between estimated glomerular filtration rate and aortic propagation velocity (r = 0.587, P < 0.001).

Figure 5. Correlation analysis between estimated glomerular filtration rate and epicardial fat thickness (r = -0.453, P < 0.001).

Figure 6. Correlation analysis between estimated glomerular filtration rate and carotid intima-media thickness (r = -0.640, P < 0.001).

**Table 1.** The Demographic and Clinical Data of the Study Population
	Stage I (n = 76)	Stage II (n = 39)	Stage III (n = 25)	Stage IV (n = 15)	Stage V (n = 15)	P value
aStage I vs. other groups. ^bStage II vs. other groups. ^cStage III vs. other groups. ^dStage IV vs. other groups. BMI: body mass index.
Age (years)	52.2 ± 12.6	63.4 ± 10.3^a	63.9 ± 8.6^a	59.8 ± 12.2	63.6 ± 4.6^a	< 0.001
Male, n (%)	53 (70)	27 (69)	14 (56)	8 (53)	7 (47)	0.293
BMI (kg/m²)	29.3 ± 5.0	28.9 ± 3.3	29.0 ± 4.9	29.4 ± 4.5	30.1 ± 5.5	0.940
Diabetes mellitus, n (%)	22 (29)	10 (25)	8 (32)	6 (40)	3 (20)	0.145
Coronary artery disease, n (%)	32 (42)	20 (51)	19 (76)^{a, b}	4 (27)^c	13 (87)^{a, b, d}	0.001
Hypertension, n (%)	35 (46)	34 (87)^a	18 (72)	15 (100)^a	5 (33)^{b, d}	< 0.001
Smoking, n (%)	37 (49)	22 (57)	12 (48)	6 (40)	13 (87)	0.065
Hyperlipidemia, n (%)	24 (32)	15 (40)	13 (52)	12 (80)^a	3 (20)^d	0.003
White blood cell count (10³/mm³)	8.1 ± 2.0	8.5 ± 2.5	8.8 ± 1.9	6.0 ± 1.4^{a, b, c}	7.5 ± 0.8	< 0.001
Hemoglobin (g/dL)	13.9 ± 1.8	12.7 ± 1.8^a	12.7 ± 1.0^a	11.5 ± 1.8^a	10.2 ± 2.6^{a, b, c}	< 0.001
Creatinine (mg/dL)	1.0 ± 0.2	1.3 ± 0.1^a	1.9 ± 0.6^{a, b}	3.8 ± 0.5^{a, b, c}	5.9 ± 0.4^{a, b, c, d}	< 0.001
Sodium (mEq/L)	137.4 ± 3.7	135.8 ± 3.1	136.8 ± 0.9	141.5 ± 5.0^{a, b, c}	134.2 ± 3.6^{a, d}	< 0.001
Albumin (g/dL)	3.5 ± 0.4	3.5 ± 0.4	3.8 ± 0.3^{a, b}	3.6 ± 0.4	3.6 ± 0.3	0.036
C-reactive protein (mg/L)	10.6 ± 8.0	15.7 ± 12.2^a	10.9 ± 7.1	7.1 ± 9.8^b	15.1 ± 6.0	0.007
Total cholesterol (mg/dL)	205.0 ± 43.2	217.2 ± 40.3	216.4 ± 46.7	213.2 ± 55.8	202.9 ± 24.2	0.534
Ejection fraction (%)	58.2 ± 6.6	57.2 ± 12.1	57.5 ± 17.9	60.6 ± 11.0	56.5 ± 3.6	0.645
Aortic propagation velocity (cm/s)	59.4 ± 19.5	51.5 ± 13.8	37.4 ± 5.8^{a, b}	26.8 ± 4.0^{a, b}	29.9 ± 6.8^{a, b}	< 0.001
Epicardial fat thickness (mm)	0.7 ± 0.2	0.7 ± 0.3	0.9 ± 0.1^a	1.2 ± 0.2^{a, b, c}	0.9 ± 0.2^{a, d}	< 0.001
Carotid intima-media thickness (mm)	0.6 ± 0.2	0.9 ± 0.3^a	0.9 ± 0.2^a	1.1 ± 0.2^{a, b}	1.1 ± 0.1^{a, b}	< 0.001
Estimated glomerular filtration rate (mL/min)	95.7 ± 7.8	72.0 ± 11.4^a	48.4 ± 6.6^{a, b}	28.2 ± 3.0^{a, b, c}	12.9 ± 4.0^{a, b, c, d}	< 0.001

Table 1. The Demographic and Clinical Data of the Study Population

Stage I (n = 76)

Stage II (n = 39)

Stage III (n = 25)

Stage IV (n = 15)

Stage V (n = 15)

P value

aStage I vs. other groups. ^bStage II vs. other groups. ^cStage III vs. other groups. ^dStage IV vs. other groups. BMI: body mass index.

Age (years)

52.2 ± 12.6

63.4 ± 10.3^a

63.9 ± 8.6^a

59.8 ± 12.2

63.6 ± 4.6^a

< 0.001

Male, n (%)

53 (70)

27 (69)

14 (56)

8 (53)

7 (47)

0.293

BMI (kg/m²)

29.3 ± 5.0

28.9 ± 3.3

29.0 ± 4.9

29.4 ± 4.5

30.1 ± 5.5

0.940

Diabetes mellitus, n (%)

22 (29)

10 (25)

8 (32)

6 (40)

3 (20)

0.145

Coronary artery disease, n (%)

32 (42)

20 (51)

19 (76)^{a, b}

4 (27)^c

13 (87)^{a, b, d}

0.001

Hypertension, n (%)

35 (46)

34 (87)^a

18 (72)

15 (100)^a

5 (33)^{b, d}

< 0.001

Smoking, n (%)

37 (49)

22 (57)

12 (48)

6 (40)

13 (87)

0.065

Hyperlipidemia, n (%)

24 (32)

15 (40)

13 (52)

12 (80)^a

3 (20)^d

0.003

White blood cell count (10³/mm³)

8.1 ± 2.0

8.5 ± 2.5

8.8 ± 1.9

6.0 ± 1.4^{a, b, c}

7.5 ± 0.8

< 0.001

Hemoglobin (g/dL)

13.9 ± 1.8

12.7 ± 1.8^a

12.7 ± 1.0^a

11.5 ± 1.8^a

10.2 ± 2.6^{a, b, c}

< 0.001

Creatinine (mg/dL)

1.0 ± 0.2

1.3 ± 0.1^a

1.9 ± 0.6^{a, b}

3.8 ± 0.5^{a, b, c}

5.9 ± 0.4^{a, b, c, d}

< 0.001

Sodium (mEq/L)

137.4 ± 3.7

135.8 ± 3.1

136.8 ± 0.9

141.5 ± 5.0^{a, b, c}

134.2 ± 3.6^{a, d}

< 0.001

Albumin (g/dL)

3.5 ± 0.4

3.8 ± 0.3^{a, b}

3.6 ± 0.4

3.6 ± 0.3

0.036

C-reactive protein (mg/L)

10.6 ± 8.0

15.7 ± 12.2^a

10.9 ± 7.1

7.1 ± 9.8^b

15.1 ± 6.0

0.007

Total cholesterol (mg/dL)

205.0 ± 43.2

217.2 ± 40.3

216.4 ± 46.7

213.2 ± 55.8

202.9 ± 24.2

0.534

Ejection fraction (%)

58.2 ± 6.6

57.2 ± 12.1

57.5 ± 17.9

60.6 ± 11.0

56.5 ± 3.6

0.645

Aortic propagation velocity (cm/s)

59.4 ± 19.5

51.5 ± 13.8

37.4 ± 5.8^{a, b}

26.8 ± 4.0^{a, b}

29.9 ± 6.8^{a, b}

< 0.001

Epicardial fat thickness (mm)

0.7 ± 0.2

0.7 ± 0.3

0.9 ± 0.1^a

1.2 ± 0.2^{a, b, c}

0.9 ± 0.2^{a, d}

< 0.001

Carotid intima-media thickness (mm)

0.6 ± 0.2

0.9 ± 0.3^a

0.9 ± 0.2^a

1.1 ± 0.2^{a, b}

1.1 ± 0.1^{a, b}

< 0.001

Estimated glomerular filtration rate (mL/min)

95.7 ± 7.8

72.0 ± 11.4^a

48.4 ± 6.6^{a, b}

28.2 ± 3.0^{a, b, c}

12.9 ± 4.0^{a, b, c, d}

< 0.001

**Table 2.** Correlation Analysis Among eGFR, APV, EFT and CIMT
	eGFR	APV	EFT	CIMT
eGFR: estimated glomerular filtration rate; APV: aortic propagation velocity; EFT: epicardial fat thickness; CIMT: carotid intima-media thickness.
eGFR	-	-	0.587	< 0.001	-0.453	< 0.001	-0.640	< 0.001
APV	0.587	< 0.001	-	-	-0.401	< 0.001	-0.628	< 0.001
EFT	-0.453	< 0.001	-0.401	< 0.001	-	-	0.522	< 0.001
CIMT	-0.640	< 0.001	-0.628	< 0.001	0.522	< 0.001	-	-

Table 2. Correlation Analysis Among eGFR, APV, EFT and CIMT

eGFR

APV

EFT

CIMT

eGFR: estimated glomerular filtration rate; APV: aortic propagation velocity; EFT: epicardial fat thickness; CIMT: carotid intima-media thickness.

eGFR

0.587

< 0.001

-0.453

< 0.001

-0.640

< 0.001

APV

0.587

< 0.001

-0.401

< 0.001

-0.628

< 0.001

EFT

-0.453

< 0.001

-0.401

< 0.001

0.522

< 0.001

CIMT

-0.640

< 0.001

-0.628

< 0.001

0.522

< 0.001

**Table 3.** Independent Predictors for Estimated Glomerular Filtration Rate by Multivariate Linear Regression Analysis
	Standardized coefficients beta	t	P
BMI: body mass index; APV: aortic propagation velocity; EFT: epicardial fat thickness; CIMT: carotid intima-media thickness.
BMI	-0.032	-0.561	0.576
APV	0.291	3.969	< 0.001
EFT	-0.131	-1.967	0.048
CIMT	-0.380	-4.694	< 0.001
Diabetes mellitus	-0.043	-0.757	0.450
Hypertension	-0.019	-0.322	0.748

Table 3. Independent Predictors for Estimated Glomerular Filtration Rate by Multivariate Linear Regression Analysis

Standardized coefficients beta

BMI: body mass index; APV: aortic propagation velocity; EFT: epicardial fat thickness; CIMT: carotid intima-media thickness.

BMI

-0.032

-0.561

0.576

APV

0.291

3.969

< 0.001

EFT

-0.131

-1.967

0.048

CIMT

-0.380

-4.694

< 0.001

Diabetes mellitus

-0.043

-0.757

0.450

Hypertension

-0.019

-0.322

0.748