Body Mass Index as an Independent Determinant of Left Ventricular Mass in Moderate-To-Advanced Chronic Kidney Disease: A Clinical Observational Study

Background: Left Ventricular Hypertrophy (LVH) is a major prognostic factor of cardiovascular morbidity and mortality in Chronic Kidney Disease (CKD). Obesity, quantified by Body Mass Index (BMI), may independently influence cardiac structural remodelling, but its relationship with left ventricular mass (LVM) in CKD is not fully established. Methods: In this cross-sectional study, M-mode and Doppler echocardiography of 573 patients with CKD at stages 3b-5 were performed. The Devereux formula was used to compute LV mass and indexed to the body surface area (LVMI). Patients were stratified by BMI (normal: 18.5–24.9 kg/m², overweight: 25–29.9 kg/m², obese: ≥30 kg/m²) and gender specific LVMI cutoffs (≥115 g/m² for men, ≥95 g/m² for women). Multivariate linear regression was conducted to ascertain the independent relationship of BMI with LVMI, having adjusted the age, sex, CKD stage, diabetes, and hypertension. Results: The independent variable of higher BMI was significantly linked to higher LVMI (b = 2.45, 95% CI 1.80-3.10, p <0.001). Patients who had high BMI and high LVMI were younger, and the ones with low BMI and high LVMI had lower eGFR. LVEF was preserved across groups, and diastolic parameters showed trends without significant differences after adjustment. Conclusion: BMI is an independent predictor of LVMI in moderate-to-advanced CKD, highlighting obesity as a modifiable determinant of myocardial remodelling. Early echocardiographic monitoring and weight control interventions are warranted.