Structural and functional myocardium changes in patients with chronic renal insufficiency

The prevalence of left ventricular hypertrophy (LVH) in chronic kidney disease (CKD) patients is higher than in the general population. In order to study the effect of metabolic disturbances on LVH we have performed a prospective cross-sectional study of 115 non diabetic patients (46 men, 69 women) with average creatinine clearance (Ccr) 24 ± 15 ml/min in the age 18 to 55 years, average 43,3 ± 11,3. LVH was diagnosed when the ventricular mass index (LVMI) was above 134 g/m2 for men and above 110 g/mІ for women. We found that in 31% patients with Ccr of 60-30 ml/min (n = 29) LVH has developed. In this group the LVMI correlated with systolic BP (r = 0,424, p = 0,031 ) and the duration of the arterial hypertension (r = 0,421, p = 0,026). The prevalence of LVH significantly (p < 0,05) increased with decreasing renal function, so it was detected in patients with Ccr 29-15 ml/min (n = 53) twice more often (62%). In this group patients LVMI correlated with age (r = 0,362, p = 0,007), systolic BP (r = 0,433, p = 0,003) and diastolic BP (r = 0,354, p = 0,001). A negative correlation was found between LVMI and serum albumin (r = -0,456, p = 0,001) and serum calcium (r = -0,347, p = 0,013 ) levels. 76% of patients had LVH at the beginning of dialysis treatment (Ccr <15 ml/min) (n = 33). In this case LVMI had the correlated with C-reactive protein level (r = 0,496, p = 0,008). The date of the linear regression analyze demonstrated that age, systolic BP, serum calcium level and CRP were the predictors of LVH (R2 = 0,429).

гипертрофия левого желудочка, хроническая почечная недостаточность, факторы риска, сердечно-сосудистые заболевания

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