TY - JOUR
T1 - Vitamin D receptor activation and left ventricular hypertrophy in advanced kidney disease
AU - Thadhani, Ravi
AU - Appelbaum, Evan
AU - Chang, Yuchiao
AU - Pritchett, Yili
AU - Bhan, Ishir
AU - Agarwal, Rajiv
AU - Zoccali, Carmine
AU - Wanner, Christoph
AU - Lloyd-Jones, Donald
AU - Cannata, Jorge
AU - Thompson, Taylor
AU - Audhya, Paul
AU - Andress, Dennis
AU - Zhang, Wuyan
AU - Ye, Jun
AU - Packham, David
AU - Singh, Bhupinder
AU - Zehnder, Daniel
AU - Manning, Warren J.
AU - Pachika, Ajay
AU - Solomon, Scott D.
PY - 2011/3
Y1 - 2011/3
N2 - Background: In chronic kidney disease (CKD), left ventricular hypertrophy (LVH) is prevalent and is associated with increased cardiovascular morbidity and mortality. Vitamin D receptor (VDR) activation attenuates LVH progression in animal models. Methods: PRIMO is a multinational, randomized, double-blinded trial with oral paricalcitol in subjects with stages 3-4 CKD, mild-to-moderate LVH and an LV ejection fraction >50%. The primary endpoint is change in the left ventricular mass index (LVMI) compared with placebo after 48 weeks of treatment. The main secondary endpoints are changes in diastolic function parameters. In this paper, we report baseline characteristics from this study. Results: LVMI was 33.0 ± 7.5 g/m 2.7 for males and 30.8 ± 7.2 g/m 2.7 for females (p = 0.04). LVMI correlated with systolic blood pressure (r = 0.24), urine albumin creatinine ratio (r = 0.39), troponin T (r = 0.29), high-sensitivity C-reactive protein (r = 0.25) and plasma levels of B-type brain natriuretic peptide (r = 0.22); all p < 0.01. In multiple linear regression, each remained independently associated with LVMI. The early diastolic velocity of the lateral mitral annulus (E') was 8.1 ± 2.4 cm/s. E' was inversely correlated with age in univariate (r = -0.14, p = 0.04) and multivariable (p = 0.02) analysis. Conclusion: Among 227 multinational subjects with stages 3-4 CKD, baseline LVMI correlates with baseline blood pressure, urine albumin creatinine ratio and cardiac biomarkers, and baseline diastolic function correlates with age. This research was funded by Abbott Laboratories; ClinicalTrials.gov No. NCT00497146.
AB - Background: In chronic kidney disease (CKD), left ventricular hypertrophy (LVH) is prevalent and is associated with increased cardiovascular morbidity and mortality. Vitamin D receptor (VDR) activation attenuates LVH progression in animal models. Methods: PRIMO is a multinational, randomized, double-blinded trial with oral paricalcitol in subjects with stages 3-4 CKD, mild-to-moderate LVH and an LV ejection fraction >50%. The primary endpoint is change in the left ventricular mass index (LVMI) compared with placebo after 48 weeks of treatment. The main secondary endpoints are changes in diastolic function parameters. In this paper, we report baseline characteristics from this study. Results: LVMI was 33.0 ± 7.5 g/m 2.7 for males and 30.8 ± 7.2 g/m 2.7 for females (p = 0.04). LVMI correlated with systolic blood pressure (r = 0.24), urine albumin creatinine ratio (r = 0.39), troponin T (r = 0.29), high-sensitivity C-reactive protein (r = 0.25) and plasma levels of B-type brain natriuretic peptide (r = 0.22); all p < 0.01. In multiple linear regression, each remained independently associated with LVMI. The early diastolic velocity of the lateral mitral annulus (E') was 8.1 ± 2.4 cm/s. E' was inversely correlated with age in univariate (r = -0.14, p = 0.04) and multivariable (p = 0.02) analysis. Conclusion: Among 227 multinational subjects with stages 3-4 CKD, baseline LVMI correlates with baseline blood pressure, urine albumin creatinine ratio and cardiac biomarkers, and baseline diastolic function correlates with age. This research was funded by Abbott Laboratories; ClinicalTrials.gov No. NCT00497146.
KW - Chronic kidney disease
KW - Left ventricular hypertrophy
KW - Vitamin D receptor
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U2 - 10.1159/000323551
DO - 10.1159/000323551
M3 - Article
C2 - 21242674
AN - SCOPUS:78651409106
VL - 33
SP - 139
EP - 149
JO - American Journal of Nephrology
JF - American Journal of Nephrology
SN - 0250-8095
IS - 2
ER -