Determinants of left ventricular hypertrophy and its progression in high-flux haemodialysis.
OBJECTIVE
To identify factors contributing to the development and progression of left ventricular hypertrophy (LVH) in patients on high-flux haemodialysis.


METHODS
Fifty patients without clinical cardiac disease underwent baseline echocardiography, related measurements and follow-up studies 6-12 months later.


RESULTS
Residual urea clearance was lower (0.7 +/- 1.1 vs. 2.2 +/- 2.4 ml/min; p = 0.034) while systolic blood pressure (162 +/- 21 vs. 147 +/- 11 mm Hg; p = 0.003), duration of dialysis dependence (38 +/- 37 vs. 17 +/- 13 months; p = 0.004) and interdialytic weight gain (1.98 + 0.84 vs. 1.32 + 1.08 kg; p = 0.026) were higher in those with LVH. Parathyroid hormone changed less in those whose LVH regressed (186 +/- 89 vs. 303 +/- 280 pg/ml; p = 0.032). Regression did not occur when parathyroid hormone was >300 pg/ml. ACE gene polymorphism did not affect LVH development or progression.


CONCLUSIONS
Systolic hypertension, duration of dialysis dependence and high interdialytic weight gains promote LVH. Hyperparathyroidism retards LVH regression.
Kong
Chiew H
CH
Renal Unit, Lister Hospital, Stevenage, UK. chiew@kch86.fsnet.co.uk
Farrington
Ken
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000150:complications; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D014463:Ultrasonography; D015430:Weight Gain
D010281:Parathyroid Hormone; D007703:Peptidyl-Dipeptidase A