Cardiac remodeling in chronic kidney disease associated with overweight and obesity

Chronic kidney disease (CKD) is among the most prevalent non-communicable diseases globally and is recognized as a significant independent risk factor for cardiovascular complications (CVCs). The co-occurrence of overweight or obesity in patients with CKD exacerbates its role as a risk factor for CVCs. Objective. To evaluate the characteristics of left ventricular myocardial remodeling in chronic kidney disease patients with comorbid overweight or obesity, thereby assessing their potential role as a risk factor for cardiovascular complications. Materials and methods. A total of 485 patients with CKD (291 males and 194 females, with a mean age of 43.8 years) were examined. Patients were divided into two groups: CKD with overweight (n=298) and CKD with obesity (n=187). All participants underwent clinical assessments, laboratory tests, and echocardiographic examinations. Results. Patients in the CKD with overweight group exhibited lower hematocrit, red blood cell count, and glomerular filtration rate (GFR), as well as elevated potassium and creatinine levels, compared with those in the CKD with obesity group. Notably, C-reactive protein and glucose levels were markedly higher in the obesity group, whereas 24-hour proteinuria was more significant among overweight patients. Furthermore, the obese cohort had increased levels of total cholesterol and triglycerides. Echocardiographic evaluations revealed that left ventricular (LV) linear dimensions, myocardial mass, and left ventricular mass index (LVMI) were statistically significantly greater in the CKD with obesity group. Concentric LV remodeling was observed in 7.4% of patients with overweight and 5.9% of those with obesity. LV hypertrophy was identified in 51.7% of cases (47.3% in the CKD with overweight group and 58.8% in the CKD with obesity group). Eccentric LV hypertrophy was significantly more prevalent in both patient groups. Concentric hypertrophy was primarily observed in males in the CKD with obesity group, while eccentric hypertrophy was more common among females. A correlation was established between LVMI and the estimated GFR (r = –0.397). Conclusions. In patients with chronic kidney disease who are also classified as overweight, cardiac remodeling predominantly manifests as eccentric left ventricular hypertrophy. As body mass index increases, the incidence of concentric left ventricular hypertrophy also rises, particularly in male patients.