Predicting chronic kidney disease progression from cardiac fibrosis: an interplay between two major organ systems

Abstract

Objective: Cardiovascular disease and chronic kidney disease are two major medical conditions leading to significant morbidity, mortality, and medical spending globally; nevertheless, the exact underlying pathophysiological background linking those two conditions is missing without known predictive variables. Methods: We have performed a retrospective cohort study in a tertiary university hospital on 12 patients in order to investigate the association between fibrosis score on cardiac magnetic resonance imaging study and estimated glomerular filtration rate over a 24-month follow-up period. We have referred to fibrosis scores below 1050 as no fibrosis, fibrosis scores between 1050 and 1100 as mild-to-moderate fibrosis, and scores above 1100 as severe fibrosis on T1-weighted imaging. Results: Twelve patients, 9 males and 3 females, with a mean age of 49.3 have been included in this cohort study. We have demonstrated that T1-weighted magnetic resonance imaging global fibrosis score, basal segment fibrosis score, and septal fibrosis score have been negatively associated with baseline and follow-up estimated glomerular filtration rate measurements while only T1-weighted mid-segment fibrosis score has been linked to delta estimated glomerular filtration rate. Additionally, we have demonstrated that the T1-weighted cardiac fibrosis score has been linked to serum C-reactive protein level. Conclusion: We have demonstrated the association between T1-weighted cardiac magnetic resonance imaging fibrosis scores and kidney functions in our cohort study. Our study is significant by being the first clinical study investigating such an association. Nevertheless, there is a clear need for future large-scale randomized clinical trials in order to better understand the link between cardiac fibrosis and kidney functions. © 2024 Turkish Society of Nephrology. All rights reserved.