Key result
Increased left atrial size is a powerful predictor of mortality, major adverse cardiovascular events, and renal disease progression in patients with early and end-stage chronic kidney disease.
Left atrial enlargement is a powerful predictor of adverse cardiovascular and renal outcomes in patients with chronic kidney disease, suggesting its potential utility as a surrogate endpoint in clinical trials.
Altered left ventricular (LV) mass and function are classical hallmarks of cardiomyopathy in chronic kidney disease (CKD). The left atrium (LA), a heart chamber exquisitely sensitive to volume overload and diastolic function, is an independent predictor of death and adverse cardiovascular (CV) events in high-risk patients such as those with hypertension and/or with heart failure. In this review we focus on the relationship of LA size with LV diastolic function, and the association between LA enlargement and CV and renal outcomes in patients with CKD, including patients with end-stage renal disease. Increased LA size emerges as a powerful predictor of mortality and major adverse CV events in both end-stage and early CKD, and some studies also show a close association between enlarged LA and renal disease progression. Secondary analyses of clinical trials suggest that the LA has the potential to be elected as a surrogate end point in CKD patients but the issue remains to be tested in specifically designed clinical studies.
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Paoletti et al. (2013) conducted a review in Chronic kidney disease. Left atrial enlargement was evaluated on Mortality, major adverse cardiovascular events, and renal disease progression. Increased left atrial size is a powerful predictor of mortality, major adverse cardiovascular events, and renal disease progression in patients with early and end-stage chronic kidney disease.
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