Study On The Relationship Among Body Mass Index , Blood Lipid Level And Left Ventricular Structure And Function In Non-dialysis Patients With Chronic Kidney Disease In Stage 4-5

Objective: To investigate the occurrence of abnormal left ventricular structure and function in non-dialysis patients with chronic kidney disease stage 4-5,analyze the correlation between body mass index,lipid index and left ventricular structure and function index,and explore the influence of body mass index and lipid level on left ventricular hypertrophy.Methods: 136 non-dialysis patients with CKD4-5 were admitted to the Affiliated Hospital of Qinghai University from November 2016 to October 2018.According to the staging standard of CKD,patients were divided into CKD4 group and CKD5 group,and the collected data were analyzed statistically.Results:1.Hemoglobin and serum calcium in CKD4-5 patients decreased with the decrease of renal function,while serum phosphorus and parathyroid hormone increased with the decrease of renal function,and the difference was statistically significant(P < 0.05).The incidence of left ventricular hypertrophy,left ventricular diastolic dysfunction,left ventricular systolic dysfunction and left ventricular enlargement were 77.94%,83.82%,9.56% and 8.82% in 2.136 patients with CKD,of which 69.09%,81.81%,5.45% and 9.09% in CKD4 patients and 83.95%,85.19% and 12.35% in CKD5 patients respectively.(9.88%)and the incidence of these four diseases increased with the decline of renal function,among which left ventricular hypertrophy was significantly different between the two groups(P < 0.05).3.Left ventricular posterior wall thickness,left ventricular mass index,interventricular septum thickness,left ventricular end-diastolic diameter and body mass index(r = 0.565,0.436,0.522,0.496,all P < 0.001)were positively correlated;left ventricular end-diastolic diameter(r=-0.228,P = 0.008)was negatively correlated with high density lipoprotein cholesterol.4.Compared with the non-left ventricular hypertrophy group,the body mass index,systolic blood pressure,diastolic blood pressure,serum creatinine,blood phosphorus and parathyroid hormone were higher in the left ventricular hypertrophy group,and the estimated glomerular filtration rate and high density lipoprotein cholesterol were lower(P < 0.05).In multivariate logistic regression analysis,body mass index and systolic blood pressure were independent risk factors for left ventricular hypertrophy.Conclusions: In CKD4-5 non-dialysis patients,abnormal left ventricular structure and function are common.Left ventricular diastolic dysfunction and left ventricular hypertrophy are the most common,and the incidence increases with the decline of renal function.2.High BMI and low HDL cholesterol have some effects on left ventricular structural abnormalities in non-dialysis patients with CKD4-5,but they are not enough to affect left ventricular function.3.Body mass index and systolic blood pressure are independent risk factors for left ventricular hypertrophy in CKD4-5 non-dialysis patients.