Risk Factors For Left Ventricular Hypertrophy In Patients With Chronic Kidney Disease Who Are Not On Dialysis

Objective:By collecting the relevant clinical data of not dialysis patients with chronic kidney disease(CKD)with left ventricular hypertrophy(LVH),analyzing the structure change of risk factors for heart,deepen the understanding of the cardiovascular complications in patients with chronic kidney disease and provide a reference for the prevention of cardiovascular events in patients with chronic kidney disease(CKD),reduce the incidence of cardiovascular complications and mortality in patients with nephropathy.Methods:Using retrospective analysis method,selecting inpatients of Nephrology,Sino-Japanese Friendship Hospital,Jilin University from January to November 2017,according to the inclusion and exclusion criteria,combined with the definition of CKD clearly proposed by Kidney Disease: Improving Global Outcomes(KDIGO),to select admission case data of 98 patients with clear diagnosis of chronic kidney disease and no hemodialysis may cause left ventricular hypertrophy related factors of CKD patients,including general information(gender,age,etc.)and biochemical indicators(such as urea nitrogen,serum creatinine,etc.).In the Department of Ultrasound of our hospital,we collected 3 related indicators of echocardiography of the above patients: IVS(end-diastolic ventricular septal thickness),IVD(end-diastolic left interior diameter)and LVPW(left ventricular posterior wall thickness),calculating the left ventricular mass index(LVMI),which is a quantitative indicator representing left ventricular hypertrophy,by using the above-mentioned cardiac index.According to the presence or absence of combined left ventricular hypertrophy,the two groups were divided into group A(left ventricular hypertrophy group)B(no left ventricular hypertrophy group),multivariate logistic regression was used to analyze the correlation and degree of correlation between various factors and left ventricular hypertrophy SPSS21.0 software was used for statistical analysis,and P < 0.05 indicated that the difference was statistically significant.Results:(1)There was no significant difference in primary renal disease composition between CKD patients in group A and B.The difference between two groups of patients was not statistically significantin in gender(P = 0.323),age(P = 0.930),height(P = 0.322),body weight,body mass index(P = 0.103)(P = 0.293),smoking history(P = 0.780),alcohol(P = 0.818),diastolic blood pressure(P = 0.067)(P > 0.05),The mean systolic blood pressure was higher in group A than in group B,and the difference was statistically significant(P<0.05).(2)The incidence of left ventricular hypertrophy in CKD patients was correlated with glomerular filtration rate,with statistical difference(P<0.05),and the incidence of left ventricular hypertrophy in stage 4 and 5 CKD patients in group A was significantly higher than that in the same period patients in group B,with significant decrease in glomerular filtration rate(GFR < 30ml/min)in group A,indicating group A has higher incidence of left ventricular hypertrophy.(3)Biochemical index analysis of CKD patients: the differences in urea nitrogen,blood phosphorus,calcium phosphorus product,uric acid and PTH levels between the two groups were statistically significant(P<0.05),and the levels of urea nitrogen,blood phosphorus,calcium phosphorus product,uric acid and PTH in group A were significantly higher than those in group B.There was no significant difference in serum creatinine,serum lipid,serum calcium between the two groups(P>0.05).(4)Risk factors for left ventricular hypertrophy in CKD patients: high serum phosphorus(OR=4.61,95%ci =1.31-16.25,P<0.05)and high uric acid level(OR=1.02,95%ci =1.01-1.03,P<0.05)were positively correlated with left ventricular hypertrophy,and were independent risk factors for left ventricular hypertrophy.(5)Multi-factor two correlation analysis: the blood urea nitrogen,phosphorus and the calcium-phosphorus product and PTH has significant positive correlation between the two(P < 0.05),the above factors affect each other,uric acid has no correlation with the above factors(P > 0.05).Conclusion:1.The occurrence of left ventricular hypertrophy in CKD patients is related to the glomerular filtration rate,which can occur in the early stage of nephropathy.When the glomerular filtration rate drops significantly(GFR < 30ml/min),the incidence of left ventricular hypertrophy increases significantly.2.Urea nitrogen,blood phosphorus,calcium phosphorus product,uric acid,PTH and systolic blood pressure are correlated with left ventricular hypertrophy in CKD patients.High phosphorus and hyperuricemia are independent risk factors for left ventricular hypertrophy in CKD patients and positively correlated with left ventricular hypertrophy.The higher the level of both,the higher the risk of left ventricular hypertrophy.3.Left ventricular hypertrophy in patients with chronic kidney disease was not related to gender,age,smoking,drinking or other personal history.