Left ventricular hypertrophy in predialysis chronic kidney disease: Impact of cardiomuscular stress markers

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  • KIMURA Tomonori
    Department of Nephrology, Rinku General Medical Center, Izumisano Municipal Hospital
  • IIO Ken-ichiro
    Department of Nephrology, Rinku General Medical Center, Izumisano Municipal Hospital Department of Geriatric and Nephrology, Osaka University School of Medicine
  • OBI Yoshitsugu
    Department of Nephrology, Rinku General Medical Center, Izumisano Municipal Hospital
  • HAYASHI Terumasa

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  • 透析前慢性腎臓病における左室肥大に関する心筋バイオマーカーを用いた評価
  • トウセキゼン マンセイ ジンゾウビョウ ニ オケル サシツ ヒダイ ニ カンスル シンキン バイオマーカー オ モチイタ ヒョウカ
  • Impact of cardiomuscular stress markers

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Abstract

Left ventricular hypertrophy (LVH), which is a strong predictor of mortality in patients with endstage renal disease, is present in over 70% of patients commencing dialysis. However, only a few studies on LVH are available in patients before the start of dialysis treatment. The purpose of this study was to evaluate the prevalence and clinical correlates of LVH in patients with advanced stages of chronic kidney disease (CKD).<br>We performed a cross-sectional study of 90 patients who had renal diseases but no history of either cardiovascular diseases or arrhythmia. Circulating levels of human atrial natriuretic peptide (hANP) were also measured.<br>LVH was present in 40.0% of the study population. The prevalence of LVH tended to increase with progression of renal decline: 22.7% in stage 3, 43.6% in stage 4, and 48.3% in stage 5 (creatinine clearance>10mL/min) (p=0.15). Univariate analyses revealed that hANP and albumin were significantly different between the groups with and without LVH. Stepwise logistic regression analysis showed that hANP and albumin were selected as the independent risk factors.<br>These findings suggest that strict control of body fluid and nutrition could prevent the progression of LVH, and as a result, could attenuate the risk of cardiovascular events in CKD.

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