Aldosterone is associated with left ventricular hypertrophy in hemodialysis patients.
OBJECTIVE
Patients with chronic kidney disease present a higher degree of left ventricular hypertrophy than expected for hypertension levels. In chronic kidney disease the plot between the quotient extracellular water/total body water and aldosterone is shifted up and to the right. There are few studies that verified the role of aldosterone in cardiac remodeling in this set of patients. The aim of this study was to evaluate the relationship between serum aldosterone and left ventricular mass index in patients with chronic kidney disease on hemodialysis.


METHODS
The patients were submitted to clinical and laboratory evaluation, bioelectrical impedance, echocardiography and ambulatory blood pressure monitoring. The 27 patients included were divided into two groups according to aldosterone level and compared with each other.


RESULTS
The group of patients with higher aldosterone levels had higher left ventricular mass index. These groups were heterogeneous with regard to ambulatory systolic blood pressure, body mass index, and aldosterone levels and homogeneous with regard to the quotient extracellular water/total body water, renin-angiotensin-aldosterone system blockers, beta blocker use and other clinical characteristics. The association between aldosterone levels and left ventricular mass index was adjusted to confounding variables by a multiple linear regression analysis in which aldosterone was independently associated with left ventricular mass index.


CONCLUSIONS
The data presented are consistent with a pathogenic role of aldosterone in left ventricular hypertrophy in patients with chronic kidney dialysis in dialysis patients.


BACKGROUND
ClinicalTrials.gov identifier: NCT01128101.
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Curso de Farmácia da Faculdade Sudoeste Paulista - FSP, Rua João Miguel Rafael. 440, CEP 18602-220 - Botucatu - SP, Brazil gmmfds@yahoo.com.br.
Greicy Mara Mengue
GM
Feniman De Stefano
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Silméia Garcia
SG
Zanati-Basan
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Laercio Martins
LM
De Stefano
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Viviana Rugolo Oliveira E
VR
Silva
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Patrícia Santi
PS
Xavier
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Pasqual
P
Barretti
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Roberto Jorge
RJ
da Silva Franco
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Jacqueline Costa Teixeira
JC
Caramori
Departamento de Clínica Médica da Faculdade de Medicina de Botucatu - UNESP, Botucatu - SP, Brazil.
Luis Cuadrado
LC
Martin
D000450:Aldosterone / Q000097:blood / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*
D000450:Aldosterone; D002097:C-Reactive Protein
aldosterone; hemodialysis; left ventricular hypertrophy