Supplemental Digital Content is available in the text. Chronic kidney disease (CKD) is associated with incident cardiovascular morbidity and mortality. Whether subclinical cardiovascular disease and target organ damage is associated with incident CKD is unknown. We investigated the relations of echocardiographic left ventricular mass (LVM) with incident CKD. We evaluated 2258 Framingham Offspring cohort participants (mean age, 57 years; 56% women) who underwent echocardiography at a routine examination and had an estimated glomerular filtration rate ≥60 mL/min per 1.73 m2. We used Cox proportional hazards regression with discrete time intervals to relate sex-standardized LVM (independent variable) to the incidence of CKD, defined as estimated glomerular filtration rate <60 L/min per 1.73 m2, on follow-up. During a median follow-up of 14.6 years, 373 (16.5%) participants developed incident CKD. Higher LVM was associated with higher risk of CKD after adjusting for prevalent cardiovascular disease, body mass index, systolic blood pressure, total and HDL (high-density lipoprotein) cholesterol, antihypertensive medication, smoking, and diabetes mellitus (hazard ratio, 1.15 [95% CI, 1.03–1.29]; P=0.017) per 1-SD increase in LVM g/m2. Further adjustment for baseline estimated glomerular filtration rate (adjusted hazard ratio, 1.16 [95% CI, 1.04–1.31]; P=0.010) and baseline urine albumin/creatinine ratio (adjusted hazard ratio, 1.18 [95% CI, 1.04–1.33]; P=0.009) slightly attenuated the association. In our community-based sample, LVM was associated with incident CKD prospectively, which suggests that the relations between CKD and subclinical cardiovascular disease may be bidirectional. Further studies are needed to confirm our findings.

中文翻译：

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左心室肿块和事件慢性肾脏病

文本中提供了补充数字内容。慢性肾脏病 (CKD) 与心血管疾病的发病率和死亡率有关。亚临床心血管疾病和靶器官损害是否与 CKD 事件相关尚不清楚。我们调查了超声心动图左心室质量 (LVM) 与 CKD 事件的关系。我们评估了 2258 名弗雷明汉后代队列参与者（平均年龄 57 岁；56% 为女性），他们在常规检查中接受了超声心动图检查，估计肾小球滤过率≥60 mL/min/1.73 m2。我们使用具有离散时间间隔的 Cox 比例风险回归将性别标准化 LVM（自变量）与 CKD 的发病率联系起来，CKD 定义为随访时估计的肾小球滤过率 <60 L/min/1.73 m2。在 14.6 年的中位随访期间，373 名 (16.5%) 参与者出现 CKD。在调整了流行的心血管疾病、体重指数、收缩压、总胆固醇和 HDL（高密度脂蛋白）胆固醇、抗高血压药物、吸烟和糖尿病后，较高的 LVM 与较高的 CKD 风险相关（风险比，1.15 [95 % CI，1.03–1.29]；P=0.017) LVM g/m2 每增加 1-SD。进一步调整基线估计肾小球滤过率（调整后的风险比，1.16 [95% CI，1.04-1.31]；P=0.010）和基线尿白蛋白/肌酐比（调整后的风险比，1.18 [95% CI，1.04-1.33] ; P = 0.009）略微减弱了关联。在我们基于社区的样本中，LVM 与 CKD 事件具有前瞻性相关，这表明 CKD 与亚临床心血管疾病之间的关系可能是双向的。