title: Left ventricular remodeling and arterial remodeling in patients with chronic kidney disease stage 1-3.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is an independent factor for cardiovascular system complications, such as arterial hypertension, left ventricular hypertrophy (LVH), heart failure or accelerated atherosclerosis progression. The aim of the paper was to analyze left ventricular and arterial remodeling in patients with CKD stages 1-3 to identify the subclinical marker of cardiovascular system damage which changes first in the course of CKD.
  
  
  METHODS
  The examined group consisted of 90 patients with CKD stage 1-3 and 30 subjects constituting the control group. Left ventricular mass index (LVMI), left ventricular relative wall thickness (RWT) and ejection fraction (EF) were determined by echocardiographic examination. Pulse wave velocity (PWV) between the carotid and femoral arteries as well as common carotid artery intima-media thickness (IMT) was measured. 24-h ambulatory blood pressure monitoring was performed in all subjects.
  
  
  RESULTS
  No differences were found between blood pressure values in the examined groups of patients with CKD1, CKD2 and CKD3. Concentric remodeling was found in 20.0%, concentric hypertrophy in 22.2% and eccentric hypertrophy in 18.9% of patients. LVMI values in patients with CKD2 and 3 were higher than in the control group. IMT values in patients with CKD3 were higher than in patients with CKD2. PWV in patients with stage 3 CKD was significantly higher than in the control group (p < 0.05).
  
  
  CONCLUSIONS
  In the course of CKD, the left ventricle undergoes remodeling earlier than large arterial vessels. Echocardiographic assessment of LVH in early stages of CKD may identify patients at increased cardiovascular risk.
authors.affiliation: a Department of Community Nursing, Faculty of Health Sciences , Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University , Torun , Poland .
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Pluta
authors.affiliation: b Chair and Clinic of Nephrology, Arterial Hypertension and Internal Diseases, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University , Torun , Poland , and.
authors.forename: Paweł
authors.initials: P
authors.lastname: Stróżecki
authors.affiliation: c Chair and Department of Laboratory Medicine, Faculty of Pharmacy , Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University , Torun , Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krintus
authors.affiliation: c Chair and Department of Laboratory Medicine, Faculty of Pharmacy , Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University , Torun , Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Odrowąż-Sypniewska
authors.affiliation: b Chair and Clinic of Nephrology, Arterial Hypertension and Internal Diseases, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University , Torun , Poland , and.
authors.forename: Jacek
authors.initials: J
authors.lastname: Manitius
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D059168:Carotid Intima-Media Thickness; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D051436:Renal Insufficiency, Chronic / Q000145:classification / Q000150:complications*; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D059289:Vascular Stiffness / Q000502:physiology*; D020257:Ventricular Remodeling
keywords: Chronic kidney disease; left ventricular myocardial hypertrophy; pulse wave velocity; vascular stiffness