Epidemiological Investigation And Influential Factors Of LVH In Patients With CKD In Tianjin

Objective:Chronic kidney disease(CKD)lead to various complications resulting in a decline in survival rate,including cardiovascular disease(CVD)such as coronary heart disease,acute myocardial infarction,arrhythmia,and congestive heart failure.Left ventricular hypertrophy(LVH)can be considered the most important predictors of death for patients with CKD.Research has shown that LVH was closely related to the prognosis of patients with CKD,LVMI each fell by 10%,a 28%lower risk of death from cardiovascular complications.Study for the incidence of LVH and its influencing factors in CKD without renal replacement therapy was not much,this study analysis cardiac hypertrophy related risk factors in CKD nondialysis patients,The aim is to intervene in influencing factors,,improving the survival rate and quality of life.Methods:A total of 223 patients with CKD were selected from the department of nephrology of Tianjin medical general hospital from April 2017 to December2017.There were 152 males and 71 females.General information was collected including medical history,primary disease,gender,age,first blood pressure after admission(systolic and diastolic blood pressure),hemoglobin(Hb),fasting plasma glucose(FPG),serum albumin(ALB),low-density lipoprotein cholesterol(LDL),high-density lipoprotein cholesterol(HDL),triglycerides(TC),cholesterol(TG),serum creatinine(Scr),serum uric acid(UA),serum sodium(Na)serum calcium(Ca),phosphorus(P),potassium(K),parathyroid hormone(PTH),brain natriuretic peptides(BNP).Collect data relevant to the echocardiographic,cover left ventricular diameter(LVD),left atrial diameter(LAD),right ventricular diameter(RVD),right atrial diameter(RAD),left ventricular posterior wall thickness(LVPWT),interventricular septum thickness(IVST).To calculate the relevant data,LVMI is more than 115g/m~2(male),or more than 95g/m~2(female),which is determined as LVH.SPSS21 was used for statistical analysis,and P<0.05 was considered statistically significant.Results:there were 104 cases of LVH,61 males,43 females,119 non-LVH,91males and 28 females.LVH group of SBP,DBP,P,Scr,PTH,BNP and urinary protein were higher than non-LVH group,LVH group of Hb,Ca were lower than the non-LVH group and non-LVH group the percentage of male was higher than LVH group.There were no significant difference in age,BMI,BSA,NA,K,UA,GLU,TC,TG,HDL,LDL and ALB between the tow group.The binary logistic regression analysis showed that systolic blood pressure and hemoglobin were independent factors of LVH in CKD.Conclusion:1.The most common primary pathogenesis of CKD in Tianjin were primary glomerular disease,hypertensive nephropathy and diabetic nephropathy.There was no difference in the prevalence of LVH in three common causes,and the prevalence of LVH in patients with malignant hypertrophy was 100%,which should be taken seriously in clinic.2.The prevalence of LVH in patients with CKD in the Tianjin increased with the progression of CKD,and the prevalence of LVH in the eGFR<60ml/min was higher than that in patients with CKD of eGFR>60-90ml/min.3.The prevalence of LVH in patients with non-renal replacement therapy CKD in Tianjin area was 46.64%.4.Systolic blood pressure(OR 95%CI 1.021-1.062)and hemoglobin(OR 95%CI0.946-0.983)were independent factors of LVH in CKD.The higher the systolic pressure,the higher the likelihood of hypertrophy;The higher the hemoglobin,the lower the likelihood of hypertrophy.