A clinical study of left ventricular hypertrophy and weight gain in chronic hemodialysis patients.

Abstract Background Patients with end-stage renal disease are exposed to extreme volume shifts and thereby cardiovascular strain as a consequence of interdialytic weight gain, fluid removal during hemodialysis and also chronic fluid overload. In long-term hemodialysis patients, higher IDWG (interdialytic weight gain) is associated with poor survival and increased cardiovascular death. Patients with the lowest interdialytic fluid retention have the greatest survival. It was found that increased interdialytic volume load is associated with increased both LVMI and FGF-23 level. Objective To evaluate correlation between hypervolemia, left ventricular hypertrophy and FGF-23 in prevalent hemodialysis patients. Patients and Methods This cross sectional study was conducted in Ain shams university hospital and Al Agoza hospital, on 60 prevalent hemodialysis patients.Three patient died during the study. Results FGF-23 had a positive correlation with (weight gain, (PO4)3-, PTH, IVS, PW and LVMI). Conclusion FGF-23 might be a marker of volume overload and LVH in ESRD patients, as it positively correlated with (weight gain, IVS, PW and LVMI). FGF-23 is a marker of bone diseases, as it positively correlated with (PO4)3- and PTH. Volume overload has a negative impact on morbidity and mortality in ESRD patients.

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P1300CARDIOVASCULAR COMPLICATIONS IN HEMODIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1300 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Helaoui Fadwa

Keyword(s):

Pulmonary Hypertension ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Clinical Status ◽

Vena Cava ◽

Cardiovascular Complications ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Chronic Hemodialysis ◽

Cardiac Ultrasound

Abstract Background and Aims Cardiovascular complications are the leading cause of morbidity and mortality among dialysis patients. We aim to determine the cardiac damage showed by trans-thoracic ultrasound and to identify the various factors associated with it. Method Fourty chronic hemodialysis patients have benefited of transthoracic ultrasound during this year (2019). Clinical findings were collected from patients’ medical files. Data collected included demographics, Clinical Status and echocardiographic parameters. All the patients included in this study gave their consent. Data were collected and analysed using SPSS software. Chi-squared test with a level of significance of 0.05 was used for the qualitative variables. Results The mean age of our population is 53.1 (range: 26-78) with a sex ratio equal to 0.9. 72.5% of patients are hypertensive; 27.5% of patients are diabetic. Only 2 patients to be coronary. In this study, 11 patients remained asymptomatic while 29 patients (75.5%) presented with cardiac symptomatology: 39.7% complained of chest pain, 27.5% presented with acute dyspnea and 24,1% a pericardial rub. Rhythm disorders were objectified in electrocardiography in 3 patients (1 ventricular extrasystole and 2 cardiac arrhythmia by atrial fibrillation). Twenty percent of the cardiac ultrasounds performed are without abnormalities. Cardiac ultrasound revealed the presence of valvulopathies in 40% with 20% valve calcifications. Left ventricular hypertrophy is evident in 55% of patients, 45% of whom are hypertensive. Segmental hypokinesia was observed in 27.5% and pulmonary hypertension was observed in 37.5%. Cardiac ultrasound also showed dilated right cavities in 22.5% of cases and dilated left cavities in 32.5%. Dilatation of the inferior vena cava is observed only in 3 patients. Pericarditis is highlighted in 37.5% of which 36.3% are of medium abundance and 18.1% are of great abundance without signs of compression. Clinical data were correlated with echocardiographic findings. A correlation was found between left venticular hypertrophy and hypervolemia (p=0.001) and between perdialytic hemodynamic instability and ischemic cardiopathy (p=0.04) as well as pulmonary hypertension and vascular access dysfunction (p=0.02). Conclusion Cardiovascular complications are very common in chronic hemodialysis population. The left ventricular hypertrophy is the main cause of heart disease with predominance of high blood pressure as an associated comorbidity.

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Protein Carbonyl Content Is a Predictive Biomarker of Eccentric Left Ventricular Hypertrophy in Hemodialysis Patients

Diagnostics ◽

10.3390/diagnostics9040202 ◽

2019 ◽

Vol 9 (4) ◽

pp. 202

Author(s):

Zorica M. Dimitrijevic ◽

Sonja S. Salinger Martinovic ◽

Valentina N. Nikolic ◽

Tatjana P. Cvetkovic

Keyword(s):

Oxidative Stress ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Independent Predictor ◽

Hemodialysis Patients ◽

Protein Carbonyl ◽

Left Ventricular ◽

Chronic Hemodialysis ◽

Protein Carbonyls ◽

Oxidative Protein Modification

High prevalence of left ventricular hypertrophy (LVH) and elevated oxidative stress are associated with poor outcomes in chronic hemodialysis patients. Abnormal left ventriculаr geomеtry and different geometric patterns play an important role as well. Our study analyzed the role of oxidative stress on myocardial remodeling in these patients. Plasma malondialdehyde (MDA), protein carbonyl (PC) content, and total antioxidative capacity (TAC) were investigated in 104 hemodialysis patients together with transthoracic echocardiography. Compared to patients with normal ventricular geometry, patients with LVH had increased MDA and PC plasma concentration. Multivariate analysis demonstrated that protein carbonyls, as biomarkers of oxidative protein modification, were an independent predictor of eccentric hypertrophy (eLVH), including higher LV end-diastolic diameter and LV end-diastolic volume, (β = 0.32 and β = 0.28, p < 0.001 for both). The incidence of eLVH increased progressively from the lowest to the highest baseline PC tertile (p < 0.001 for the trend) and the subjects in the former group showed a 76% greater risk of developing eLVH compared to their counterparts. After further adjustment for the potential mediators, PCs carried eLVH odds (95% confidence interval (CI)) of 1.256 (0.998–1.514), per standard deviation increase. High plasma protein carbonyls levels are a significant independent predictor of eccentric LVH in chronic hemodialysis patients.

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Measurement of the serum levels of serum troponins I and T, albumin and C-Reactive protein in chronic hemodialysis patients and their relationship with left ventricular hypertrophy and heart failure

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2018.11.029 ◽

2019 ◽

Vol 13 (1) ◽

pp. 522-525 ◽

Cited By ~ 1

Author(s):

Mohammad Saad Forghani ◽

Mohammad Sedigh Jadidoleslami ◽

Seyyed Nima Naleini ◽

Mohsen Rajabnia

Keyword(s):

Heart Failure ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Serum Levels ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Chronic Hemodialysis ◽

C Reactive Protein ◽

Reactive Protein

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Elevated plasma c-terminal fibroblast growth factor, but not intact FGF23 or soluble Klotho, is associated with left ventricular hypertrophy in pediatric chronic hemodialysis patients

Bone Abstracts ◽

10.1530/boneabs.4.p12 ◽

2015 ◽

Author(s):

Shweta Shah ◽

Eileen Brewer ◽

Poyyapakkam Srivaths

Keyword(s):

Growth Factor ◽

Left Ventricular Hypertrophy ◽

Fibroblast Growth Factor ◽

Ventricular Hypertrophy ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Chronic Hemodialysis ◽

Fibroblast Growth ◽

Elevated Plasma

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Relationship between left ventricular hypertrophy and plasma renin activity in chronic hemodialysis patients.

Journal of the American Society of Nephrology ◽

10.1681/asn.v8111764 ◽

1997 ◽

Vol 8 (11) ◽

pp. 1764-1770

Author(s):

D V Vlahakos ◽

G Hahalis ◽

P Vassilakos ◽

K P Marathias ◽

S Geroulanos

Keyword(s):

Left Ventricular Hypertrophy ◽

Plasma Renin Activity ◽

Ventricular Hypertrophy ◽

Interventricular Septum ◽

Plasma Renin ◽

Posterior Wall ◽

Hemodialysis Patients ◽

Left Ventricular ◽

Chronic Hemodialysis ◽

Posterior Wall Thickness

Left ventricular hypertrophy (LVH) is very common in uremic patients. It was shown previously that hemodialysis patients are chronically exposed to the extremes of plasma renin activity due to differences in the original renal disease. Because nonhemodynamic factors seem to play a fundamental role in the development of LVH, the present study was undertaken to investigate the relationship between the predialysis renin level and the echocardiographically determined cardiac structure in stable hemodialysis patients, matched for other parameters known to participate in the development of LVH, such as age; gender; body mass index; interdialytic weight gain; heart rate; systolic, diastolic, and mean arterial BP; hematologic and biochemical profile; vascular access; adequacy of dialysis; nutritional status; and period of follow-up. Thirty-three such patients were stratified in three groups according to predialysis renin levels: group A (n = 11), with renin levels < or = 1 ng.ml-1.h-1; group B (n = 9), with renin levels between 1 and 4 ng.ml-1.h-1; and group C (n = 13), with renin levels > or = 4 ng.ml-1.h-1. LVH with disproportionate septal thickening was directly related to the degree of renin-angiotensin system activation, and values for interventricular septum thickness, posterior wall thickness, interventricular septum thickness/posterior wall thickness ratio, left ventricular mass, and left ventricular mass index were all significantly correlated with predialysis renin levels. Because angiotensin II promotes growth in both fibroblasts and cardiac myocytes, these relationships suggest that elevated renin levels may be causally associated with the development of LVH in chronic hemodialysis patients.

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