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Long-term evolution and changing associations of left ventricular hypertrophy after starting hemodialysis

Atsushi Takeda1, Takayuki Toda, Hitoshi Iwamoto

  • 1Kidney Center, Tsuchiura Kyodo General Hospital, Ibaraki, Japan. atakeda@midorino.com

Nephron. Clinical Practice
|October 22, 2008
PubMed

Insights

Left ventricular hypertrophy (LVH) is common in dialysis patients. While LVH slightly decreased after starting hemodialysis, baseline LV mass and blood pressure control are key factors for regression.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Medicine

Background:

  • Left ventricular hypertrophy (LVH) is a common condition in patients undergoing dialysis.
  • LVH is a significant risk factor for cardiovascular diseases in this population.

Purpose of the Study:

  • To investigate the changes in left ventricular mass (LVM) after initiating hemodialysis.
  • To identify the factors influencing these changes in LV mass.

Main Methods:

  • A cohort of 107 patients was studied.
  • Echocardiograms were performed at yearly intervals after starting hemodialysis.
  • Changes in LV mass index (LVMI) were correlated with clinical and laboratory parameters.

Main Results:

  • At baseline, 68% of patients had LVH with a mean LVMI of 145.8 g/m(2).
  • Over a mean follow-up of 34.5 months, LVMI decreased by 3.9 g/m(2) to 141.5 g/m(2).
  • Significant correlations were found between LVMI changes and baseline LVMI, systolic blood pressure, serum albumin, and age.

Conclusions:

  • LVH is prevalent in dialysis patients and often persists after starting treatment.
  • Baseline LV mass and systolic blood pressure control are primary determinants of LV mass changes.
  • Early antihypertensive treatment is recommended to regress LVH and reduce cardiovascular risk.
Abstract

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