Risk Factors of Left Ventricular Hypertrophy in CAPD Patients.
- Author:
Dong Ki KIM
1
;
Young Suck GOO
;
Hyun Jin KIM
;
Heung Jong KIM
;
Tae Hee LEE
;
Ho Young MAENG
;
Sung Pil HONG
;
Yong Soo KIM
;
In Hyun JUNG
;
Hoon Young CHOI
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Ho Yung LEE
;
Dae Suk HAN
Author Information
1. Departments of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea. khchoi6@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Left ventricular hypertrophy;
Left ventricular mass index;
CAPD
- MeSH:
Anemia;
Blood Pressure;
Body Mass Index;
Calcium;
Diabetic Nephropathies;
Echocardiography;
Follow-Up Studies;
Glomerulonephritis;
Hand;
Hematocrit;
Humans;
Hyperparathyroidism, Secondary;
Hypertrophy, Left Ventricular*;
Kidney Failure, Chronic;
Linear Models;
Mortality;
Nephrosclerosis;
Parathyroid Hormone;
Peritoneal Dialysis, Continuous Ambulatory*;
Retrospective Studies;
Risk Factors*;
Serum Albumin
- From:Korean Journal of Nephrology
2002;21(6):966-974
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Left ventricular hypertrophy (LVH) is a critical and an independent factor for mortality of patients with end-stage renal disease, and numerous risk factors for LVH have been discussed in previous studies. In present study, we intended to clarify the factors that affect the progression of LVH in patients with their first continuous ambulatory peritoneal dialysis (CAPD) and to analyse the influences of these risk factors on severity of LVH. METHODS: This retrospective study enrolled the patients who performed echocardiography both before and in period between 24 to 30 months after CAPD. We estimated the change of LVH by the calculated difference of left ventricular mass index (LVMI) on echocardiography. We analyzed the factors that influence the change of LVMI such as age, sex, baseline renal disease, body mass index, blood pressure, hematocrit, calcium, phosphate, intact parathyroid hormone (i-PTH), serum albumin and peritoneal transport status on peritoneal equilibration test (PET). RESULTS: The causes of renal disease of the patients (male : female=10 : 16, mean age 55.74+/-12.0 years) were as follows : 13 cases (50.0%) of diabetic nephropathy, 11 cases (47.4%) of chronic glomerulonephritis, 1 case (3.8%) of hypertensive nephrosclerosis, and 1 case (3.8%) of unknown cause. Mean duration of follow-up was 25.5+/-2.1 months. As a result, the difference of LVMI positively correlated with mean systolic blood pressure (p=0.001, r=0.598) and mean diastolic blood pressure (p<0.001, r=0.718), difference of pulse pressure (p<0.001, r=0.893), and maximal i-PTH level (p=0.041, r=0.404). On the other hand, the difference of LVMI showed negative correlation with mean hematocrit (p=0.031, r=-0.421). In multiple linear regression analysis, the mean diastolic blood pressure and the difference of pulse pressure appeared to be the independent risk factors for the difference of LVMI (R2=0.923). CONCLUSION: The factors necessary to restrict the progression of LVH after initiation of CAPD are strict blood pressure control, correction of anemia, optimal treatment of secondary hyperparathyroidism. These corrections could secure the amelioration of LVH.
