Publication Date:
2013-12-17
Description:
Aim Mortality, predominantly due to cardiovascular events, is high in patients with chronic kidney disease (CKD) and left ventricular hypertrophy (LVH) is a strong risk factor. Vascular endothelial dysfunction (ED) is common in CKD, but its potential contribution to LVH in non-dialysis CKD is unknown. This study investigated the association of ED with LVH in non-dialysis CKD patients. Methods and results We studied 30 CKD patients (17 pre-dialysis and 13 renal transplant recipients) and 29 age–gender-matched controls. In both groups, high-sensitivity C-reactive protein (hsCRP) levels, systemic ED (brachial artery flow-mediated dilatation, FMD), and LVH using two-dimensional echocardiography were measured. LV mass index (LVMI) was calculated using Penn formula and indexed by height. CKD patients had higher CRP levels (3.9 ± 2.8 vs. 1.0 ± 0.7 mg/L; P 〈 0.001), reduced FMD (3.2 ± 2.1 vs. 6.1 ± 1.9%; P 〈 0.001), and increased LVMI (146.1 ± 40.2 vs. 105.3 ± 26.2 g/m; P 〈 0.001), compared with controls. In CKD patients, LVMI increased with decreasing FMD ( r = –0.371; P = 0.043) and FMD decreased with increasing CRP ( r = –0.741; P 〈 0.001). Patients with low FMD 〈2.3% had higher CRP and LVMI (161.9 ± 48.9 vs. 130.4 ± 20.7 g/m; P = 0.033), compared with CKD patients with FMD ≥2.3%. There was no significant difference in age, blood pressure, cholesterol, FMD, and LVMI between pre-dialysis and post-renal transplant CKD patients. In multivariate regression, the relationship between LVMI and FMD remained significant after adjusting for age, diabetes, and smoking (adjacent beta = –0.396; P = 0.004). Conclusion This pilot study demonstrates for the first time a relationship of ED with LVH in non-dialysis CKD patients; suggesting but not proving a cause–effect relationship.
Print ISSN:
1525-2167
Electronic ISSN:
1532-2114
Topics:
Medicine
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