Document Detail

Hypertension, left ventricular hypertrophy and chronic kidney disease.
MedLine Citation:
PMID:  21116711     Owner:  NLM     Status:  In-Data-Review    
Left ventricular hypertrophy (LVH) is a cardiovascular complication highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease. LVH in CKD patients has generally a negative prognostic value, because it represents an independent risk factor for the development of arrhythmias, sudden death, heart failure and ischemic heart disease. LVH in CKD patients is secondary to both pressure and volume overload. Pressure overload is secondary to preexisting hypertension, but also to a loss of elasticity of the vessels and to vascular calcifications, leading to augmented pulse pressure. Anemia and the retention of sodium and water secondary to decreased renal function are responsible for volume overload, determining a hyperdynamic state. In particular, the correction of anemia with erythropoietin in CKD patients is advantageous, since it determines LVH reduction. Other risk factors for LVH in CKD patients are documented: some are specific to CKD, as mineral metabolism disorders (hypocalcemia, hyperphosphatemia, low serum vitamin D levels and secondary hyperparathyroidism), others are non-traditional, such as increased asymmetric dimethylarginine, oxidative stress, hyperhomocysteinemia and endothelial dysfunction that, in turn, accelerates the process of atherogenesis, triggers the inflammation and pro-thrombotic state of the glomerular and the vascular endothelium and aggravates the process of both CKD and LVH.
Stefano Taddei; Renato Nami; Rosa Maria Bruno; Ilaria Quatrini; Ranuccio Nuti
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart failure reviews     Volume:  16     ISSN:  1573-7322     ISO Abbreviation:  Heart Fail Rev     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-08-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612481     Medline TA:  Heart Fail Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  615-20     Citation Subset:  IM    
Department of Internal Medicine, University of Pisa, Pisa, Italy.
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