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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Kidney function and risk factors for left ventricular hypertrophy in untreated uncomplicated essential hypertension

Francesco Perticone1, Raffaele Maio, Carmen Ruberto

  • 1Department of Experimental and Clinical Medicine, G. Salvatore, University Magna Graecia of Catanzaro, Reggio Calabria, Italy.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|April 22, 2008
PubMed

Insights

Decreased kidney function is linked to left ventricular hypertrophy in hypertensive patients, partly due to factors like insulin resistance. This highlights the cardiovascular impact of kidney health.

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Syndrome

Background:

  • Left ventricular (LV) hypertrophy and reduced kidney function are significant cardiovascular risk factors in hypertensive individuals.
  • Hypertension management requires understanding multifactorial risks for cardiac complications.

Purpose of the Study:

  • To investigate the relationship between kidney function markers (creatinine, creatinine clearance, eGFR) and left ventricular mass (LVM) in patients with essential hypertension.
  • To determine if kidney function independently predicts LV mass and to explore mediating factors.

Main Methods:

  • Cross-sectional study of 400 untreated hypertensive patients.
  • Measured LV mass index (LVMI), estimated glomerular filtration rate (eGFR) using the MDRD equation, and serum creatinine.
  • Assessed Framingham risk factors, endothelial function (ACh-stimulated FBF), insulin sensitivity (HOMA-R), C-reactive protein (CRP), and uric acid.

Main Results:

  • Both eGFR and creatinine levels showed significant associations with LVMI (P < 0.001).
  • eGFR remained independently associated with LVMI after adjusting for Framingham risk factors.
  • This association weakened after accounting for specific factors like insulin resistance (HOMA-R), endothelial function, CRP, and uric acid.
  • A significant interaction was found between eGFR and insulin resistance in explaining LVMI variability (P = 0.007).

Conclusions:

  • Decreased kidney function independently contributes to left ventricular hypertrophy in hypertensive patients.
  • The link between kidney function and LVMI is partly mediated by insulin resistance, endothelial dysfunction, CRP, and uric acid levels.
  • Kidney function and insulin resistance interact synergistically in the development of left ventricular hypertrophy.
Abstract

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