Chonnam Med J.  1998 Dec;34(2):191-200.

Risk Factors for Left Ventricular Hypertrophy in CRF Patients on Chronic Hemodialysis

• Nah MY
• Jeong GH
• Kim HS
• Ma SK
• Choi W
• Lee SC
• Kim SW
• Kim NH
• Choi KC
• Kang YJ

Abstract

Background
Left ventricular hypertrophy(LVH) is the most common echocardio- graphic finding in CRF patients starting renal replacement therapy and is associated with increased mortality from cardiovascular disease, which is the main cause of the death in patients on chronic hemodialysis. In general, systolic hypertension and anemia have been accepted as the main risk factors for LVH. The aim of this study was to evaluate the risk factors for LVH in CRF patients on chronic hemodialysis patients.
Materials and Methods
In this study, 16 chronic hemodialysis patients of Chonnam university hospital hemodialysis unit were selected(11 women and 5 men; mean age, 46.8 years; mean time on chronic hemodialysis, 26.7 months). Several clinical and laboratory data were analyzed. The left ventricular mass and each echocardiographic parameters were estimated using Penn conventional criteria.
Results
LVH was observed in 11 patients. These 11 patients were compared with a control group(patients without LVH, n=5). The LVH group showed higher systolic blood pressures(P=0.007), diastolic blood pressures(P=0.02) and serum albumin level(P=0.04). In echocardiographic parameters, left ventricular end-diastolic diameter (LVEDD, P=0.0301), interventricular septum thickness(IVST, P=0.0307) and posterior left ventricular wall thickness(PLVWT, P=0.0084) in LVH group was higher than those in control group. And the degree of difference was greater in PLVWT than LVEDD, IVST, respectively(mean value, control group vs LVH group; 0.98 vs 1.45, 4.1 vs 5.0, 1.00 vs 1.35, each). The stepwise multiple regression analysis represented that only systolic blood pressure(t=2.910; P=0.0142), age(t=2.078; P=0.0610), BUN(t=2.314; P=0.029), and serum albumin level(t=3.061; P=0107) independently influenced the left ventricular mass index(R2=0.7769; P=0.0014).
Conclusion
This study demonstrated that hypertension is an important risk factor for LVH. Since old age was another risk factor for LVH, aggresive mana- gement of additional risk factors is needed in elderly patients with chronic renal failure.

Keyword

CRF; Chronic hemodialysis; LVH; Echocardiography; Hypertension

MeSH Terms

Aged
Anemia
Cardiovascular Diseases
Echocardiography
Female
Hemodialysis Units, Hospital
Humans
Hypertension
Hypertrophy, Left Ventricular*
Jeollanam-do
Kidney Failure, Chronic
Male
Mortality
Renal Dialysis*
Renal Replacement Therapy
Risk Factors*
Serum Albumin
Serum Albumin