Abstract: [Abstract] Objective To analyze the risk factors, prevalence and prognostic effects of left atrial enlargement (LAE) in non-dialysis patients with chronic kidney disease （CKD）.Methods From January 2018 to December 2019, patients with stage 1 to 5 CKD who had not initiated dialysis and were hospitalized in the Department of Nephrology, Xuanwu Hospital of Capital Medical University and underwent echocardiography were selected and divided into LAE group and non-LAE group according to the diagnostic criteria of LAE. The demographic and biochemical data of patients were collected. The follow-up period ended November, 2021, and all-cause death or lost follow-up were the end point event. Results Among of the 524 patients with CKD, 299 had LAE （ 57.06%，299 / 524). The results of multivariate Logistic regression analysis showed that pre-existing chronic cardiovascular disease (OR = 3.365,95% CI 1.896-5970, P <0.001), hyperlipidemia (OR = 1.845,95% CI 1.042-3.265, P=0.036) and hypocalcemia (OR = 0.273,95% CI 0.082-0.912, P <0.035) were independent influencing factors for LAE in CKD patients. CKD patients with LAE had lower survival rate than those without LAE by Kaplan-Meier analysis(Log-rankχ2=13.093，P＜0.001）whereas the multivariate Cox regression analysis showed that age (Exp (B) =1.036,95%CI 1.011~1.062, P=0.005) and combined chronic cardiovascular disease (Exp (B) =2.175,95%CI 1.133~4.176, P=0.020) were independent risk factors for all-cause death in patients with chronic kidney diseases. Conclusions Prevalence of LAE is more than 50% of patients with stages 1 to 5 CKD. Chronic cardiovascular disease, hyperlipidemia and low blood calcium were independent risk factors for CKD patients with LAE, LAE increase risk all-cause death of CKD but it is not an independent risk factors for all-cause death in non-dialysis CKD patients.

Key words: Left atrial enlargement, Chronic kidney disease, Prognosis, Risk factor