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Effect of early stage kidney disease on cardiac mass: comparison to post-donation renal function
Caroline Rugale1, Guilhem Du Cailar, Pierre Fesler
1Department of Internal Medicine and Nephrology, Centre Hospitalier Universitaire Montpellier, Montpellier, France. caroline.rugale@inserm.fr
Insights
Kidney disease amplifies left ventricular mass in patients with chronic renal failure, independent of blood pressure. This effect is more pronounced in women and linked to factors like aldosterone.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic renal failure increases cardiovascular risk, partly due to left ventricular hypertrophy.
- Parenchymal kidney disease (KD+) is common in patients with mild to moderate renal failure (stage 2-3).
Purpose of the Study:
- To evaluate the influence of parenchymal kidney disease on left ventricular geometry in normotensive patients with mild to moderate renal failure.
- Compare left ventricular geometry between patients with kidney disease (KD+) and healthy kidney donors (KD-).
Main Methods:
- Retrospective monocentric study involving 50 patients with kidney disease (KD+) and 63 healthy controls (KD-).
- Echocardiography used to assess left ventricular geometry.
- Comparison of left ventricular mass (LVM) indexed to body surface area between groups.
Main Results:
- Left ventricular mass (LVM) indexed to body surface area was significantly greater in KD+ patients compared to KD- subjects.
- The increase in LVM was more pronounced in women than in men.
- Multivariate analysis identified kidney disease as an independent determinant of LVM index, irrespective of age, gender, and blood pressure.
Conclusions:
- Parenchymal kidney disease has an independent amplifying effect on left ventricular mass.
- This effect may be related to volume overload and/or prohypertrophic factors, such as aldosterone.
Background/Aim:
In chronic renal failure the increase in cardiovascular risk is in part related to the high prevalence of left ventricular hypertrophy. The aim of the present monocentric retrospective study was to evaluate the influence of the presence of parenchymal kidney disease on left ventricular geometry in normotensive (arterial pressure <140/90 mm Hg) patients (KD+, n = 50, mean age 39 ± 19 years) with mild to moderate renal failure (stage 2-3 chronic kidney disease).
Methods:
Left ventricular geometry was estimated by echocardiography and compared to a group of healthy subjects with similarly reduced renal function as a consequence of renal donation (KD-, n = 63, mean age 52 ± 12 years).
Results:
Subjects with and without kidney disease had similar blood pressure, body mass index and isotopic glomerular filtration rate. Left ventricular mass (LVM) indexed to body surface area was greater in KD+ as compared to KD- subjects and the difference was more pronounced in women than in men. The increase in LVM in KD+ patients was associated with lower albuminemia and hematocrit, and a higher plasma renin activity and aldosterone as compared to KD- subjects. In multivariate analysis, kidney disease emerged as an important determinant of LVM index independently of age, gender and blood pressure.
Conclusion:
This observation suggests that the presence of kidney disease has an independent amplifying effect on LVM which could be related to volume overload and/or prohypertrophic factors such as aldosterone.
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