Role of aldosterone in left ventricular hypertrophy among African-American patients with end-stage renal disease on hemodialysis.
OBJECTIVE
Recently, serum aldosterone levels have been reported to play a significant role in cardiac hypertrophy. One study of Japanese patients correlated aldosterone levels with the degree of left ventricular hypertrophy (LVH) in those undergoing hemodialysis. However, the role of aldosterone in LVH in non-Japanese patients with end-stage renal disease (ESRD) has not been established.


METHODS
Researchers evaluated 42 [29 African-Americans (69%), 11 Caucasians (26%), and 2 other (5%)] male ESRD patients on dialysis for more than 6 months. Pre- and postdialysis, blood pressures and aldosterone and renin concentrations were measured. Transthoracic echocardiography was performed and left ventricular mass (LVM) index was calculated using the Devereaux formula. Medications were reviewed.


RESULTS
There were no differences noted in medications prescribed for African-Americans and for Caucasians. Additionally, data from diabetic patients showed no statistically significant correlation between LVM index and any of the variables, including pre- and postdialysis blood pressure, serum potassium, renin, and aldosterone levels, for African-Americans compared to Caucasians. Data from nondiabetic patients showed a positive correlation between LVM and plasma aldosterone concentration in African-Americans (n = 10). Data from nondiabetic Caucasians were disregarded because only one was studied.


CONCLUSIONS
LVM and aldosterone correlate in African-American males with ESRD on hemodialysis without diabetes. This has important implications for the etiology of, and therapy for LVH in this population. Larger studies are needed to determine whether the same associations exist in females and Caucasians.
Steigerwalt
Susan
S
Division of Nephrology and Hypertension, Department of Medicine, St. John Hospital and Medical Center, Detroit, Mich 48236, USA. spspnhp@aol.com
Zafar
Abida
A
Mesiha
Nancy
N
Gardin
Julius
J
Provenzano
Robert
R
D001741:Black or African American; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D044465:White People
D000450:Aldosterone