Left ventricular hypertrophy in chronic kidney disease: A diagnostic criteria comparison

Nutr Metab Cardiovasc Dis. 2021 Jan 4;31(1):137-144. doi: 10.1016/j.numecd.2020.08.028. Epub 2020 Sep 12.

Abstract

Background and aims: CKD patients have a high prevalence of LVH and this leads to an increase of cardiovascular risk. The aim of this study was to assess the prevalence of left ventricular hypertrophy (LVH) and left ventricular geometry in a group of 293 hypertensive patients with stage 2-5 chronic kidney disease (CKD), compared with 289 essential hypertensive patients with normal renal function.

Methods and results: All patients underwent echocardiographic examination. Patients on stage 1 CKD, dialysis treatment, or with cardiovascular diseases were excluded. LVH was observed in 62.8% of patients with CKD and in 51.9% of essential hypertensive patients (P < 0.0001). We found increasingly higher left ventricular diameters, thicknesses, and mass from stage 2-5 CKD. Distribution of concentric and eccentric LVH was not very different between the two groups. However, after introducing mixed hypertrophy, the difference between the two groups group was disclosed (P = 0.027). Multiple regression analysis confirmed that the association between renal function and left ventricular mass (β -0.287; P < 0.0001) was independent by potential confounders. Diastolic function was significantly worse in patients with CKD, especially in more advanced stages.

Conclusion: Our study confirms that LVH is highly prevalent in patients with CKD, especially by using the most recent cut off; in this population, LVH is often characterized by the simultaneous increase of wall thicknesses and diameters with negative effects on diastolic function.

Keywords: CKD; Echocardiography; Hypertension; Letf ventricular hypertrophy; Ventricular geometry.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Cross-Sectional Studies
  • Essential Hypertension / diagnosis
  • Essential Hypertension / epidemiology
  • Essential Hypertension / physiopathology
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology*
  • Hypertrophy, Left Ventricular / physiopathology
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Assessment
  • Ventricular Function, Left
  • Ventricular Remodeling
  • Young Adult