Effect of early stage kidney disease on cardiac mass: comparison to post-donation renal function.
OBJECTIVE
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.


CONCLUSIONS
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.
Department of Internal Medicine and Nephrology, Centre Hospitalier Universitaire Montpellier, Montpellier, France. caroline.rugale@inserm.fr
Caroline
C
Rugale
Guilhem
G
Du Cailar
Pierre
P
Fesler
Jean
J
Ribstein
Georges
G
Mourad
Albert
A
Mimran
D000293:Adolescent; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D014019:Tissue Donors; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult
D000450:Aldosterone