Effect Factors Of Left Ventricular Hypertrophy In Maintenance Hemodialysis Patients

Objective:Cardiovascular disease is the leading cause of death in patients with end-stage renal disease and maintenance hemodialysis.Left ventricular hypertrophy(LVH)can increases cardiovascular risk and all-cause mortality.Therefore,controlling the risk factors of left ventricular hypertrophy can improve the survival rate of patients with end-stage renal disease maintenance hemodialysis.This study analyzed the influence factors of left ventricular hypertrophy in patients with maintenance hemodialysis and provided an evidence for clinical treatment.Method In this study,80 patients with chronic renal insufficiency who underwent maintenance hemodialysis in the second blood purification center of our hospital from June 2013 to June 2017 were selected as the study subjects.Their general indicators were recorded,including age,sex,height,dry weight,primary disease,hypertension,diabetes mellitus,and clinical index include serum albumin,hemoglobin(Hb),serum calcium,phosphorus,parathyroid hormone(PTH),alkaline phosphatase(ALP),serum uric acid(Ur),eGFR,BMI,interventricular septum thickness(IVST),left ventricular posterior wall thickness(PWT),left ventricular end diastolic diameter(LVEDD),and calculated left ventricular mass index(LVMI).For male,LVMI≥115 g/m~2 is diagnosed as LVH,and LVMI≥95 g/m~2 for female.We compare left ventricular hypertrophy group with left ventricular non-hypertrophy group.Results 80 patients were enrolled in our study.There were 38 patients in the left ventricular hypertrophy group and 42 patients in the left ventricular non-hypertrophy group.The two groups were analyzed by single factor analysis.LVH group had lower calcium[(1.93±0.24)vs(2.04±1.88),P=0.038],lower BMI[(21.22±3.53)vs(23.02±2.34),P=0.008],lower eGFR[(6.23±2.23)vs(10.19±8.75),P=0.040],and higher PTH than left ventricular non-hypertrophy group,and higher PTH[(306.84±164.06)vs(241.57±164.03),P=0.040]than the left ventricular non-hypertrophy group,the difference has statistical difference(P<0.05).The Logistic regression analysis showed that low calcium[OR 20.847,95%CI 1.332 to 326.192 P,=0.030],low BMI[OR 1.301,95%CI 1.075 to 1.576 P,=0.007],low eGFR[OR 1.229,95%CI 1.031 to 1.464 P,=0.021],high PTH[OR 0.996,95%CI 0.992 to 1.P=0.035]are the independent risk factors of left ventricular hypertrophy in maintenance hemodialysis patients.Conclusion Low calcium,high PTH,low BMI,and low eGFR are the independent risk factors of left ventricular hypertrophy in maintenance hemodialysis patients.