title: Plasma aldosterone and its relationship with left ventricular mass in hypertensive patients with early-stage chronic kidney disease.
abstract: Plasma aldosterone concentrations (PACs) are often increased in the advanced stages of chronic kidney disease (CKD); however, PAC has not been fully investigated in early CKD. Moreover, little is known about the relationship between aldosteronemia and left ventricular (LV) mass in subjects with mild-to-moderate CKD. The study objectives were to analyze PAC, LV mass (LVM), LV geometry and their relationships, in a group of hypertensive patients with stage I-III CKD. One hundred ninety-five hypertensive patients with stage I-III CKD were enrolled and compared with a control group of 82 hypertensive patients without renal dysfunction. LVM was higher in subjects with CKD than in the control group and increased progressively with advancing stages of CKD (P=0.004). A similar trend was observed for PAC (P<0.0001), in which PAC was greater in CKD subjects with LV concentric geometry than in those with eccentric LV hypertrophy (P=0.01). Furthermore, in CKD patients, PAC was directly and significantly correlated with LVM (r=0.29; P<0.0001) and with relative wall thickness (RWT; r=0.36; P<0.0001). These associations remained significant even after adjustment for various confounding factors in multiple regression analyses (P<0.001). In summary, the results demonstrated that in CKD hypertensive patients, LVM, RWT and PAC are increased and related to each other from the earliest stages of renal dysfunction. Furthermore, it seems biologically plausible to speculate that aldosterone may promote a concentric geometry of the left ventricle and increase LVM in hypertensive patients with early CKD.
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mulè
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Nardi
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Guarino
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cacciatore
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Geraci
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Calcaterra
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Oddo
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vaccaro
authors.affiliation: Dipartimento Biomedico di Medicina Interna, e Specialistica (DIBIMIS), Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
authors.forename: Santina
authors.initials: S
authors.lastname: Cottone
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000473:pathology*; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000150:complications / Q000473:pathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology*; D014527:Uric Acid / Q000097:blood; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D014527:Uric Acid; D000450:Aldosterone; D003404:Creatinine