Study On The Relationship Between Renal Function And Left Ventricular Hypertropgy In Patients With Chronic Renal Disease

Objective: To investigate the changes of renal function and the related factors of renal function deterioration in patients with CKD;to explore the risk factors associated with left ventricular hypertrophy and the influence of left ventricular hypertrophy on the prognosis of renal disease in patients with CKD.Methods:1)According to the inclusion and exclusion criteria,patients with non-dialysis chronic kidney disease who were treated in our hospital and regularly followed up;2)Collect baseline data of patients when they were enrolled,including general data,laboratory indicators,blood pressure,cardiac ultrasound results and medication;3)According to the left ventricular myocardial mass index,the left ventricular hypertrophy group and the left ventricle non-hypertrophic group were compared.The general data and clinical indicators were compared between the two groups.The logistic regression analysis was used to analyze the risk factors related to left ventricular hypertrophy.4)According to whether The endpoint events were divided into renal function stabilization group and renal function progression group.The demographic and laboratory indicators were compared between the two groups.Kaplan-Meier curve was used to analyze the influence of left ventricular hypertrophy on the prognosis of kidney disease.COX risk model was used to analyze the progress of CKD.Risk factors associated with the use of ROC curve to analyze the predictive effect of left ventricular myocardial mass index on renal function progression.Results:1)Basic information: 109 people were included in the study,59 males and 50 females,with an average age of(50.61±11.87)years and an average eGFR(47.65±27.65)ml/min/1.73 m2.Follow-up results:a median follow-up of 36 months;32 of them had an endpoint.2)renal function progression combined with hypertension ratio,baseline serum creatinine,phosphorus,serum cystatin C,parathyroid hormone,24 h urine protein quantitation,urinary albumin creatinine ratio,systolic blood pressure,diastolic blood pressure,left ventricular hypertrophy ratio,ACEI drug use rate,eGFR,plasma albumin,low calcium,low hemoglobin concentration(P <0.05),multivariate analysis showed high serum creatinine,high urine protein,decreased hemoglobin,increased diastolic blood pressure,left ventricular hypertrophy An independent risk factor for the progression of CKD.3)There were 40 cases of left ventricular hypertrophy in 109 patients,accounting for 36.7%.Compared with the left ventricular non-hypertrophy group,the left ventricular hypertrophy group had low BMI,high proportion of smokers,low proportion of drinkers,and low use of ACEI/ARB drugs.Low plasma albumin,high blood P,high calcium-phosphorus product,and 24 h urine protein increased(P<0.05).In the left ventricular hypertrophy group,the proportion of males was low,serum creatinine was high,eGFR was low,serum cystatin C was high,and hemoglobin was low(P<0.001).Two-category Logistic analysis of left ventricular hypertrophy showed that women and hemoglobin decreased to left ventricular hypertrophy.The risk factor.4)Further explore the relationship between renal function and left ventricular myocardial mass index in patients with CKD.It is found that with the decline of renal function,the left ventricular myocardial mass index also shows a gradual increase trend,and the proportion of left ventricular hypertrophy is significantly increased.5)The survival time of the left ventricular hypertrophy group was significantly less than that of the left ventricular non-hypertrophic group,indicating that left ventricular hypertrophy may affect the prognosis of CKD patients.The results of ROC curve showed that the area under the ROC curve of left ventricular hypertrophy predicting renal function progression was 0.872,95%CI(0.789-955),P < 0.001,and the critical value was 122.35 g/m2,suggesting that the left ventricular myocardial mass index The control is within 122.35g/m2,and the renal function of patients with chronic kidney disease has a good prognosis.Conclusion:Renal function progression in CKD patients correlated with basal serum creatinine value,24 h urine protein quantitation,hemoglobin,diastolic blood pressure,left ventricular hypertrophy;gender and hemoglobin affect left ventricular hypertrophy;left ventricular hypertrophy is predicted to reduce eGFR in patients with CKD by 50% or Progression to independent risk factors for end-stage renal disease.