Vitamin D receptor (VDR) gene polymorphism is associated with left ventricular (LV) mass and predicts left ventricular hypertrophy (LVH) progression in end-stage renal disease (ESRD) patients

Abstract BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemodialysis. We report the prevalence and risk factors for clinically significant arrhythmias among end stage renal disease (ESRD) patients on maintenance dialysis at a tertiary dialysis facility in Tanzania. MethodsCross-sectional study, involving consenting adults with ESRD was conducted September 2019 to February 2020. Arrhythmias were assessed using standard 5-leads Holter electrocardiography placed 15 minutes before dialysis and connected throughout dialysis. Clinically Significant Arrhythmias (CSA) was defined as ectopic beats in excess of 10 per hour or any of the ventricular tachycardia or Pause lasting for at least 2.5 seconds or paroxysmal supraventricular tachycardia or atrial flutter or atrial fibrillation. ResultsA total of 71 (44.4%) participants had CSA. Factors associated with increased risk for CSA were: age older than 60 years (OR 34; 95% CI: 5.15-236; P< 0.001), intradialytic blood pressure change of ≥ 10mmHg (OR 3.85; 95% CI: 1.27-11.7; P=0.017) and the presence of Left Ventricular Hypertrophy (OR 5.84; 95% CI: 1.85-18.4; P< 0.01). On the contrary, three dialysis sessions per week (OR 0.14; 95% CI: 0.03-0.67; P=0.013) and use of beta-blockers (OR 0.18; 95% CI: 0.05-0.68; P=0.011) were significantly associated with a decreased risk of CSA. ConclusionClinically significant arrhythmias are not uncommon in ESRD patients undergoing maintenance haemodialysis. We recommend increasing vigilance for CSA among older patients (>60 years) as well as those with left ventricular hypertrophy. Beta blockers among hypertensive ESRD patients with ventricular hypertrophy could be helpful.

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MO735INTERPLAY BETWEEN GDF-15 AND LEFT VENTRICULAR HYPERTROPHY IN END-STAGE RENAL DISEASE PATIENTS ON DIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab097.0015 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Susana Coimbra ◽

Cristina Catarino ◽

Maria do Sameiro Faria ◽

José Pedro Lopes Nunes ◽

Susana Rocha ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Renal Disease ◽

End Stage Renal Disease ◽

Ventricular Hypertrophy ◽

Tissue Injury ◽

Left Ventricular ◽

Dialysis Vintage ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract Background and Aims Cardiovascular disease (CVD) is the major cause of mortality and morbidity in chronic kidney disease (CKD), especially in end-stage renal disease (ESRD) patients. Left ventricular hypertrophy (LVH) is a common cardiovascular complication in CKD. Growth differentiation factor (GDF)-15 increases in tissue injury and inflammatory states associated with cardiometabolic risk. GDF-15 and N-terminal pro B-type natriuretic peptide (NT-proBNP) are both synthesized by cardiomyocytes and may be associated with cardiorenal dysfunction. Our aim was to study the association of GDF-15 with LVH in ESRD patients on dialysis. Method This study included 196 ESRD patients on dialysis (hemodiafiltration and high-flux hemodialysis). Left ventricular mass (LVM) was evaluated through echocardiographic studies, corrected for body surface area and the values are presented as LVM index (LVMI). LVH was defined by a value of LVMI > 115 g/m2 in men and > 95 g/m2 in women. Patients were divided into two groups - LVH (n=131) and non-LVH (n=65). LVMI, clinical and analytical variables (age, body mass index, dialysis vintage, dialysis adequacy, GDF-15, NT-proBNP and pentraxin (PTX) 3 were evaluated. Results ESRD patients with LVH presented significantly higher levels of NT-proBNP and GDF-15, and a trend towards higher PTX3 values. In LVH patients, GDF-15 correlated positively and significantly with NT-proBNP and PTX3; LVMI correlated positively and significantly with pro-BNP and PTX3 levels; pro-BNP correlated significantly and positively with PTX3. Conclusion Our data show that in ESRD patients on dialysis with LVH, GDF-15 is raised and shows a strong association with NT-proBNP, PTX3 and LVMI. Further studies are needed to clarify if the rise in GDF-15 is a cause or a consequence of LVH development. Acknowledgments This work was supported by Applied Molecular Biosciences Unit-UCIBIO, financed by national funds from FCT/MCTES (UIDB/04378/2020), by North Portugal Regional Coordination and Development Commission (CCDR-N)/NORTE2020/Portugal 2020 (Norte-01-0145-FEDER-000024) and by REQUIMTE-Rede de Química e Tecnologia-Associação in the form of a researcher (S. Rocha) – project Dial4Life co-financed by FCT/MCTES (PTDC/MEC-CAR/31322/2017) and FEDER/COMPETE 2020 (POCI-01-0145-FEDER-031322).

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