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      Left Ventricular Hypertrophy in End-Stage Renal Disease

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          Abstract

          To determine the prevalence of left ventricular hypertrophy (LVH; left ventricular wall thickness > 1–2 cm in diastole) among end-stage renal disease (ESRD) patients and the most important risk factors that independently relate to LVH, 189 non-diabetic ESRD patients without dilated cardiomyopathy in two centres had echocardiography and full clinical review. 104 of 189 (55%) patients had LVH consisting of 52 of 83 (65%) patients on haemodialysis, 18 of 20 (90%) peritoneal dialysis patients and 34 of 86 (40%) transplanted patients. Using multiple logistic regression, the most important factors which independently related to LVH, in all patients studied, were dialysis as current ESRD treatment (p < 0.001), followed by age (p = 0.008), hypertension as defined by number of blood pressure medications (p = 0.007), followed by high serum alkaline phosphatase which probably reflects hyperparathyroidism (p = 0.03). In a subset of patients with severe LVH (left ventricular wall thickness > 1.4 cm), a high serum alkaline phosphatase level was the best predictor of LVH (p < 0.001), followed by high diastolic blood pressure (p = 0.004) and age (p = 0.02). In dialysis patients, the most important variables were age (p = 0.009) and high serum alkaline phosphatase (p = 0.03). In the transplant group, patients with LVH were taking significantly more antihypertensive medications than those without LVH (p = 0.002). This variable was the only predictor of LVH in the transplant group. It is concluded that the most important factors associated with LVH in ESRD are age, hypertension, hyperparathyroidism and some factors associated with dialysis treatment, which are not functioning vascular access, anaemia or high serum creatinine. Hyperparathyroidism may be particularly important in the pathogenesis of severe LVH.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1988
          1988
          09 December 2008
          : 48
          : 2
          : 107-115
          Affiliations
          Division of Nephrology, Health Sciences Centre, Memorial University, St. John’s, Nfld.; Division of Nephrology and Transplant Service, Royal Victoria Hospital, McGill University, Montreal, P.Q., Canada
          Article
          184887 Nephron 1988;48:107–115
          10.1159/000184887
          2963965
          © 1988 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 9
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Transplantation, Left Ventricular Hypertrophy, Dialysis

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