Analysis of factors related to left ventricular hypertrophy in hemodialysis patients

Abstract

Objective To investigate the incidence and related risk factors of left ventricular hypertrophy (LVH) in hemodialysis patients. Methods A cross-sectional survey was conducted in 84 patients with maintenance hemodialysis (MHD) from the Blood Purification Centre of the Affiliated Hospital of Jiangsu University. All the patients were divided into 2 groups, the group with LVH (n=50) and the group without LVH (n=34), according to the left ventricular myocardial mass index (LVMI). The two groups were compared in the general information, blood biochemical indexes, and the color Doppler ultrasound of the heart. Spearman rank correlation and multiple linear regression analyses were used to evaluate the risk factors of LVH. Results The urea clearance index (Kt/V), hemoglobin, and dialysis age were all lower, and the systolic blood pressure was higher in the group with LVH than in the group without LVH (all P<0.05). Spearman rank correlation analysis showed that the LVMI was negatively correlated with the urea clearance index Kt/V (r=-0.342, P<0.05), and positively correlated with the ultrafiltration volume and systolic pressure (r=0.291, 0.256, respectively, both P<0.05). The multivariate linear regression analysis showed that the urea clearance index Kt/V, systolic blood pressure, and ultrafiltration volume were correlated with the LVH of the hemodialysis patients (P<0.05). Conclusions The urea clearance index Kt/V was a protective factor of LVH. High systolic pressure and high ultrafiltration volume were independent risk factors of LVH in the dialysis patients. Improvement of the dialysis adequacy and control of both the systolic blood pressure and dialysis interval fluid intake may be helpful in reducing the incidence of LVH. Key words: Maintenance hemodialysis; Left ventricular hypertrophy; Left ventricular myocardial mass index