Observational study.
We included 2,410 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort with eGFRcys > 60 mL/min/1.73 m2 at year 15 and who had an echocardiogram obtained at year 25.
eGFRcys at year 15 and rapid decline in eGFRcys (defined as >3% per year over 5 years from years 15 to 20).
LVMI measured at year 25.
We adjusted for age, sex, race, diabetes, body mass index, low- and high-density lipoprotein cholesterol levels, cumulative systolic blood pressure, and albuminuria.
Mean age was 40 ± 4 (SD) years, 58% were women, and 43% were black. After 10 years of follow-up, mean LVMI was 39.6 ± 13.4 g/m2.7. Compared with eGFRcys > 90 mL/min/1.73 m2 (n = 2,228), eGFRcys of 60 to 75 mL/min/1.73 m2 (n = 29) was associated with 5.63 (95% CI, 0.90-10.36) g/m2.7 greater LVMI (P = 0.02), but there was no association of eGFRcys of 76 to 90 mL/min/1.73 m2 (n = 153) with LVMI after adjustment for confounders. Rapid decline in eGFRcys was associated with higher LVMI compared with participants without a rapid eGFRcys decline (β coefficient, 1.48; 95% CI, 0.11-2.83; P = 0.03) after adjustment for confounders.
There were a limited number of participants with eGFRcys of 60 to 90 mL/min/1.73 m2.
Among young and middle-aged adults with preserved kidney function, eGFRcys of 60 to 75 mL/min/1.73 m2 and rapid decline in eGFRcys were significantly associated with subsequently higher LVMI. Further studies are needed to understand the mechanisms that contribute to elevated LVMI in this range of eGFRcys.