Clinical correlates and mortality impact of left ventricular hypertrophy among new ESRD patients in the United States

Stack, Austin G.; Saran, Rajiv

doi:10.1053/ajkd.2002.36881

Cited by 105 publications

(62 citation statements)

References 19 publications

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“…Several studies have, however, shown that comorbidities increase mortality among RRT patients [12][13][14], and a large European study reported that coronary artery disease, peripheral vascular disease and cerebrovascular disease all increase the risk of death by approximately 40% [9]. To our knowledge, only two small studies have estimated the effect of comorbidities on mortality in patients with diabetes on RRT, and no study has focused solely on patients with type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Comorbidities and survival of patients with type 1 diabetes on renal replacement therapy

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Comorbidities and survival of patients with type 1 diabetes on renal replacement therapy

et al. 2011

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“…1,4,5 Of the various cardiovascular complications, left ventricular hypertrophy (LVH) is one of the most prevalent 6,7 and is predictive of an increased mortality and cardiovascular death. 8,9 More than 75% of patients with CKD already had established LVH at the time of dialysis initiation. 10 The prevalence of LVH in patients with CKD who are not undergoing dialysis was lower, ranging from 32% to 75%.…”

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confidence: 99%

Longitudinal Changes of Cardiac Structure and Function in CKD (CASCADE Study)

Cai¹,

et al. 2014

Journal of the American Society of Nephrology

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Little is known regarding the natural longitudinal changes in cardiac structure and function in CKD. We hypothesized that baseline CKD stage is associated with progressive worsening in cardiac structure and function. We conducted a prospective longitudinal study, recruiting 300 patients with stages 3-5 CKD from a major regional tertiary center and university teaching hospital in Hong Kong. Baseline CKD stages were studied in relation to natural longitudinal changes in echocardiographic and tissue Doppler imagingderived parameters. Over 1 year, the prevalence of left ventricular (LV) hypertrophy increased from 40.3% to 48.9%, median left atrial volume index CKD is a global public health problem and a major risk factor for cardiovascular disease. 1,2 Cardiovascular mortality is estimated to be at least 10-to 100-fold higher in patients with ESRD than in the age-, race-, and sex-matched general population. 2 This higher mortality is attributed to an increased risk of developing accelerated atherosclerosis, vascular calcification, heart failure, and sudden cardiac death. 3 Even earlier stages of CKD are associated with an increased cardiovascular risk. 1,4,5 Of the various cardiovascular complications, left ventricular hypertrophy (LVH) is one of the most prevalent 6,7 and is predictive of an increased mortality and cardiovascular death. 8,9 More than 75% of patients with CKD already had established LVH at the time of dialysis initiation. 10 The prevalence of LVH in patients with CKD who are not undergoing dialysis was lower, ranging from 32% to 75%. 6,7,11,12 Notably, patients with an eGFR,30 ml/min per 1.73 m 2 showed a .2-fold increased risk of having LVH compared with those with an eGFR$60 ml/min per 1.73 m 2 , 6 suggesting that worsening kidney function or uremia, per se, may be an important contributing factor for LVH in CKD. Indeed, several previous cross-sectional studies have consistently shown an important inverse relationship between eGFR and left ventricular (LV) mass

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“…Morphologically, left ventricular dilation and concentric hypertrophy are approximately equally represented, and both conditions are associated with higher rates of cardiovascular events (1)(2)(3)(4)(5)(6)(7). In dialysis patients, anemia is associated with LVH, left ventricular dilation, congestive heart failure, hospitalization, and mortality (8 -11).…”

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confidence: 99%

Double-Blind Comparison of Full and Partial Anemia Correction in Incident Hemodialysis Patients without Symptomatic Heart Disease

Parfrey¹,

Foley²,

Wittreich³

et al. 2005

Journal of the American Society of Nephrology

341

302

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It is unclear whether physiologic hemoglobin targets lead to cardiac benefit in incident hemodialysis patients without symptomatic heart disease and left ventricular dilation. In this randomized, double-blind study, lower (9.5 to 11.5 g/dl) and higher (13.5 to 14.5 g/dl) hemoglobin targets were generated with epoetin ␣ over 24 wk and maintained for an additional 72 wk. Major eligibility criteria included recent hemodialysis initiation and absence of symptomatic cardiac disease and left ventricular dilation. The primary outcome measure was left ventricular volume index (LVVI). The study enrolled 596 patients. Mean age, duration of dialysis therapy, baseline predialysis hemoglobin, and LVVI were 50.8 yr, 0.8 yr, 11.0 g/dl, and 69 ml/m 2 , respectively; 18% had diabetic nephropathy. Mean hemoglobin levels in the higher and lower target groups were 13.3 and 10.9 g/dl, respectively, at 24 wk. Percentage changes in LVVI between baseline and last value were similar (7.6% in the higher and 8.3% in the lower target group) as were the changes in left ventricular mass index (16.8 versus 14.2%). For the secondary outcomes, the only between-group difference was an improved SF-36 Vitality score in the higher versus the lower target group (1.21 versus ؊2.31; P ‫؍‬ 0.036). Overall adverse event rates were similar in both target groups; higher (P < 0.05) rates of skeletal pain, surgery, and dizziness were seen in the lower target group, and headache and cerebrovascular events were seen in the higher target group. Normalization of hemoglobin in incident hemodialysis patients does not have a beneficial effect on cardiac structure, compared with partial correction.

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Clinical correlates and mortality impact of left ventricular hypertrophy among new ESRD patients in the United States

Cited by 105 publications

References 19 publications

Comorbidities and survival of patients with type 1 diabetes on renal replacement therapy

Comorbidities and survival of patients with type 1 diabetes on renal replacement therapy

Longitudinal Changes of Cardiac Structure and Function in CKD (CASCADE Study)

Double-Blind Comparison of Full and Partial Anemia Correction in Incident Hemodialysis Patients without Symptomatic Heart Disease

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