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Epidemiology and pathophysiology of left ventricular abnormalities in chronic kidney disease: a review

Giovanni Cerasola1, Emilio Nardi, Alessandro Palermo

  • 1Department of Internal Medicine, Cardiovascular and Renal Diseases, University of Palermo, Palermo, Italy. medint@unipa.it

Journal of Nephrology
|May 4, 2010
PubMed

Insights

Left ventricular hypertrophy (LVH) is common in chronic kidney disease (CKD) patients, affecting over 70% with end-stage renal disease. Early detection of LVH and diastolic dysfunction in CKD is crucial for improving cardiovascular outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Cardiovascular diseases (CVD) are a leading cause of mortality in chronic kidney disease (CKD) patients.
  • Left ventricular (LV) abnormalities, including hypertrophy (LVH) and dysfunction, are highly prevalent in CKD and worsen cardiovascular prognosis.

Purpose of the Study:

  • To review the literature on left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).
  • To understand the prevalence, determinants, and clinical implications of LVH and diastolic dysfunction in CKD.

Main Methods:

  • A literature search was conducted using PubMed for studies on left ventricular hypertrophy (LVH) in chronic kidney disease (CKD).
  • The review considered various definitions of LVH used across different studies.

Main Results:

  • Prevalence of LVH exceeds 70% in end-stage renal disease (ESRD) patients.
  • LVH prevalence increases with declining renal function in earlier stages of CKD.
  • Significant heterogeneity exists in reported LVH prevalence due to variations in study populations, GFR estimation methods, and LVH definitions.

Conclusions:

  • Major determinants of LVH in CKD include hypertension, fluid/electrolyte imbalances, and anemia.
  • Non-hemodynamic factors like RAAS activation, oxidative stress, inflammation, and growth factors also contribute to LVH.
  • LV diastolic dysfunction is common, occurs early, and is linked to heart failure and mortality, even without LVH.
  • Early identification of LVH and LV dysfunction in CKD patients may improve cardiovascular outcomes.
Abstract

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