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Determinants of left ventricular hypertrophy and its progression in high-flux haemodialysis
1Renal Unit, Lister Hospital, Stevenage, UK. chiew@kch86.fsnet.co.uk
Aim:
To identify factors contributing to the development and progression of left ventricular hypertrophy (LVH) in patients on high-flux haemodialysis.
Method:
Fifty patients without clinical cardiac disease underwent baseline echocardiography, related measurements and follow-up studies 6-12 months later.
Results:
Residual urea clearance was lower (0.7 +/- 1.1 vs. 2.2 +/- 2.4 ml/min; p = 0.034) while systolic blood pressure (162 +/- 21 vs. 147 +/- 11 mm Hg; p = 0.003), duration of dialysis dependence (38 +/- 37 vs. 17 +/- 13 months; p = 0.004) and interdialytic weight gain (1.98 + 0.84 vs. 1.32 + 1.08 kg; p = 0.026) were higher in those with LVH. Parathyroid hormone changed less in those whose LVH regressed (186 +/- 89 vs. 303 +/- 280 pg/ml; p = 0.032). Regression did not occur when parathyroid hormone was >300 pg/ml. ACE gene polymorphism did not affect LVH development or progression.
Conclusion:
Systolic hypertension, duration of dialysis dependence and high interdialytic weight gains promote LVH. Hyperparathyroidism retards LVH regression.
