MYOCARDIAL REMODELING RISK FACTORS AT STAGE II-IV CHRONIC KIDNEY DISEASE

Aim. To evaluate frequency and risk factors of development of left ventricular hypertrophy (LVH) of the heart in patients with chronic kidney disease (CKD) of stage II-IV Material and methods. The trial enrolled 83 patients (42 - 51% males, 41 - 49% females, mean age 46.7 years) with stage II-IV CKD of non-diabetic origin. Glomerular filtration rate (GFR) estimated according to Cockroft-Goult formula was 37,7 ml/min (95% confidence interval from 33,9 до 41,4). Chronic renal failure duration averaged 2,7 years (95 % CI from 2.0 to 3.3). Arterial hypertension (AH) was diagnosed in 96% patients, hereditary predisposition to cardiovascular diseases - in 54 %, obesity — in 60 %, lipid disbolism - in 66%, anemia — in 34 % and hyperphosphatemia — in 45 %; 40% patients smoked. Echocardiography was performed in all the patients. Results. LVH was detected in 31 (37.3%) of 83 patients. With progression of renalfailure, frequency of registration of LVH increased. LVH onset was associated with conventional (age, AH, high level of total cholesterol) and renal (lowering of GFR, anemia, hyperphosphatemia) factors. Concentric remodeling, concentric LVH, eccentric LVH were detected in 31.3, 19.3 and 18.1% patients, respectively. Eccentric LVH developed more frequently under the influence of factors associated with renal failure (GFR, anemia, hyperphosphatemia, hypocalciemia). Concentric LVH was characterized with the highest systolic blood pressure. Conclusion. Patients with renal dysfunction develop LVH of different geometric model associated with both conventional and renal risk factors even at early stages of CKD.