Left ventricular hypertrophy in end-stage renal disease and its possible regression as a result of correction of anemia and arterial hypertension


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Abstract

Aim. To ascertain mechanisms of development of left ventricular hypertrophy (LVH) and possible cardioprotective action of anemia correction in patients with end-stage renal disease.
Material and methods. A total of 98 patients (53 females and 45 males aged 49.4±14 years) on hemodialysis participated in the study. The patients were examined clinically with estimation of the levels of parathormone, calcium, phosphorus, erythrocytic indices, serum ferritin, blood transferrin. Echocardiography with dopplerography on Aloka-4000 unit were made. Left ventricular geometry was assessed by J. Gottdiener classification. Therapeutic policy aimed at correction of anemia, arterial hypertension, phosphorus-calcium metabolism.
Results. The patients were treated and followed up for 18 months. The examination was done before treatment, 12 and 18 months later. After the trial the patients were divided into 4 groups depending on the results obtained on LVH development. Blood pressure, hemoglobin, echocardiographic parameters changed according to the patient's group. After 18 months of observation and treatment with erythropoietin and iron preparations, ACE inhibitors, angiotensin II receptor blockers, beta-adrenoblockers, drugs regulating phosphorus-calcium metabolism some cases were seen of reduction of systolic blood pressure, achievement of target hemoglobin level, regression of LVH.
Conclusion. Combined treatment of hemodialysis patients including antianemic, antihypertensive drugs promoted improvement of LVH or its regression in some cases.

About the authors

Fatima Uruzmagovna Dzgoeva

Email: fdzgoeva@mail.ru

Tamara Magametovna Gatagonova

Zarina Kazbekovna Kadzaeva

Ol'ga Vasil'evna Khamitsaeva

Zalina Khasanovna Kochisova

Email: kochisova-zalina@mail.ru

Argentina Taymurazovna Dzutseva

Bela Georgievna Bazaeva

F U Dzgoeva

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

T M Gatagonova

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

Z K Kadzaeva

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

O V Khamitsaeva

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

Z Kh Kochisova

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

A T Dzutseva

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

B G Bazaeva

North-Osetia State Medical Academy, Vladikavkaz

North-Osetia State Medical Academy, Vladikavkaz

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