Hipertrofia ventricular esquerda em pacientes com doença renal crônica em tratamento conservador

Cardiovascular disease (CVD) remains the major cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) is present in 75% of patients starting dialysis, suggesting that LVH might be present from an early stage of CKD. Few studies have addressed the predialysis...

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Detalles Bibliográficos
Autores: Bregman, Rachel, Lemos, Carla, Pecoits Filho, Roberto, Abensur, Hugo, Draibe, Sergio Antonio [UNIFESP], Bastos, Marcus Gomes, Canziani, Maria Eugênia Fernandes [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2010
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:portugués
OAI Identifier:oai:repositorio.unifesp.br:11600/5622
Acceso en línea:http://dx.doi.org/10.1590/S0101-28002010000100014
http://repositorio.unifesp.br/handle/11600/5622
Access Level:acceso abierto
Palabra clave:chronic kidney failure
left ventricular hypertrophy
therapy
insuficiência renal crônica
hipertrofia ventricular esquerda
terapêutica
Descripción
Sumario:Cardiovascular disease (CVD) remains the major cause of death in patients with chronic kidney disease (CKD). Left ventricular hypertrophy (LVH) is present in 75% of patients starting dialysis, suggesting that LVH might be present from an early stage of CKD. Few studies have addressed the predialysis prevalence of LVH. This study evaluated 309 clinically stable patients under treatment for at least three months at five Brazilian centers. Biochemical profile and inflammatory markers were assessed. Data were shown as mean ± SD. Left ventricular hypertrophy was present in 53% of the patients, whose mean age was 60 ± 13years. The mean age of those without LVH was 55 ± 14 years. Diabetes mellitus was the underlying disease in 35% of the patients in both groups. Estimated glomerular filtration rate was 30 ± 11 and 32 ± 12 mL/min for patients with and without LVH, respectively (p = 0.19). The distribution of patients showed that 60% of those with LVH were in stage 4. Multivariate logistic regression analysis indicated the following independent determinants for LVH: age (p < 0.001); calcium (p < 0.001); hemoglobin (p < 0.048); and diastolic blood pressure (p < 0.001). Systolic blood pressure, lipids, and inflammatory markers showed no correlation with LVH. In conclusion, the incidence of LVH was high even among patients under conservative treatment, and, except for age, LVH correlated with reversible factors. The need for strictly diagnosing CKD and preventing LVH in the predialysis phase is emphasized to decrease mortality due to CVD in that population.