Association Between Aluminum Accumulation and Cardiac Hypertrophy in Hemodialyzed Patients

London, Gérard M.; Vernejoul, Marie‐Christine de; Fabiani, F; Marchais, Sylvain J.; Guérin, Alain P.; Mëtivier, Fabien; Chappuis, P.; Llach, Francisco

doi:10.1016/s0272-6386(89)80120-9

Cited by 29 publications

(9 citation statements)

References 28 publications

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“…Presence of arteriovenous fistulae, salt and water retention and anemia increased preload (18,22,23), while the changes in blood pressure and physical properties of large arteries increased afterload (22). Other putative risk factors for LVH may include age, aluminum accumulation, hyperparathyroidism and some unknown uremic toxins (22,(24)(25)(26)(27)(28). In addition to LVH, we also demonstrated that diabetic nephropathy, age and systolic blood pressure on the maintenance phase were the independent predictors for survival of dialysis patients.…”

Section: Discussionmentioning

confidence: 56%

Left Ventricular Hypertrophy Is a Risk Factor Independent of Hypertension in Survival of Hemodialyzed Patients

et al. 2002

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Hemodialysis patients have low 5-year survival rates of approximately 60%, and the most common cause of death is cardiovascular diseases. Their population may be considered, therefore, as an accelerated model in analyzing the risk factors for cardiovascular diseases. We previously reported the role of blood pressure, one of the most important risk factors for cardiovascular diseases, in determining the prognosis of hemodialysis patients. In this study, we examined the effect of cardiomegaly detected on chest roentgenogram or electrocardiogram before initiating hemodialysis therapy on survival after introduction to maintenance hemodialysis. One hundred and sixty hemodialysis patients who had no history of ischemic heart disease or arrhythmia were followed up for 88.9 +/- 4.0 months, among whom 69 died. Heart enlargement, defined on chest roentgenogram, was detected in 104 patients, and left ventricular hypertrophy, defined on electrocardiogram, was detected in 105 patients. The presence of either finding shortened their survival. However, Cox's proportional hazards model and logistic multiple regression analysis identified only left ventricular hypertrophy as one of the significant determinants for survival, but heart enlargement was not independent. Correction of systolic hypertension on the maintenance phase had no significant favorable effect on survival in patients with left ventricular hypertrophy, while it improved in those with heart enlargement. This finding, together with those above from Cox's model and logistic analysis strongly suggests that risk from left ventricular hypertrophy is independent of, but one from heart enlargement is dependent on hypertension.

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Section: Discussionmentioning

confidence: 56%

Left Ventricular Hypertrophy Is a Risk Factor Independent of Hypertension in Survival of Hemodialyzed Patients

et al. 2002

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“…It is of interest that in a study of carefully selected HD patients without a history of CVD, an increase in LV mass occurred in 56% of the patients [12]. Factors noted to be associated with LVH include hypertension, anemia [6], secondary hyperparathyroidism [12], age [13], and aluminum accumulation [14]. …”

Section: Risk Factorsmentioning

confidence: 99%

Ventricular Arrhythmias and Sudden Cardiac Death in End-Stage Renal Disease Patients on Chronic Hemodialysis

Meier

Vogt

Blanc

2001

Nephron

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“…In the same way. it has been shown that long-standing alu minum accumulation could be associated with the development of ventricular hypertrophy [31]. Recently, the role of chronic metabolicacidosis in the pathogenesis of ventricular hy pertrophy has been recognized [32], The asso ciation of chronic acidosis with LVH seemed to be related to increased plasma aldosterone and catecholamine levels observed in chroni cally acidotic dialysis patients [32],…”

Section: Left Ventricular Mass In Esrdmentioning

confidence: 99%

Pathophysiology of Left Ventricular Hypertrophy in Dialysis Patients

London¹,

Guérin²,

Marchais³

1994

Blood Purif

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Left ventricular hypertrophy is a frequent cardiovascular alteration in end-stage renal disease patients on hemodialysis which is associated with increased morbidity and mortality. Hypertrophy results from chronic flow and pressure overload and from poorly understood neurohumoral alterations. Clinical symptomatology associated with ventricular hypertrophy is related to diastolic dysfunction which characterizes this condition. The symptoms are (1) an unusual sensitivity to volume changes such that hypotension and hemodynamic instability and/or pulmonary edema occur with small volume variations and (2) a high frequency of supraventricular arrhythmias.

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Association Between Aluminum Accumulation and Cardiac Hypertrophy in Hemodialyzed Patients

Cited by 29 publications

References 28 publications

Left Ventricular Hypertrophy Is a Risk Factor Independent of Hypertension in Survival of Hemodialyzed Patients

Left Ventricular Hypertrophy Is a Risk Factor Independent of Hypertension in Survival of Hemodialyzed Patients

Ventricular Arrhythmias and Sudden Cardiac Death in End-Stage Renal Disease Patients on Chronic Hemodialysis

Pathophysiology of Left Ventricular Hypertrophy in Dialysis Patients

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