Akademik Veri Yönetim Sistemi
AMERICAN JOURNAL OF KIDNEY DISEASES, cilt.47, sa.3, ss.485-492, 2006 (SCI-Expanded)
Background: The long-term behavior of left ventricular hypertrophy (LVH) was evaluated and potential predictors of change in left ventricular mass index (LVMI) in hemodialysis (HD) patients were determined. Methods: One hundred eight patients on regular HD treatment were included. In addition to hematologic and biochemical evaluations, annual echocardiography and 24-hour ambulatory blood pressure monitoring were performed in all patients. During the median follow-up of 50 months (range, 12 to 63 months), a median of 4 echocardiographic examinations were performed in each patient. The presence of LVH was defined on the basis of an LVMI greater than 131 g/m(2) for men and greater than 100 g/m(2) for women. Results: Eighty-two patients (75.9%) had LVH at baseline. LVH status was stable in 64 patients, whereas it changed on at least 1 occasion in the remaining patients (40.7%). LVH disappeared during the first year in 8 patients and beyond the first year of dialysis therapy in an additional 9 patients. An 8.0 +/- 39.6-g/m(2) decrease in LVMI was detected between the first and final evaluations. independent predictors of change In LVMI were C-reactive protein level (P<0.001), baseline hemoglobin level (P=0.025), and baseline postdialysis systolic blood pressure (P=0.003). Twenty-four-hour systolic blood pressure was the only independent predictor of both LVMI (P<0.001) and LVH (P=0.001) at baseline. Nighttime systolic blood pressure and C-reactive protein level were found to be independent predictors of final LVMI (P<0.001 for both). Independent predictors of LVH at the end of the study were 24-hour systolic blood pressure (P=0.022) and C-reactive protein level (P=0.003), whereas hemoglobin level had marginal significance (P=0.051). Conclusion: Progressive LVH is not inevitable in HD patients. Aggressive treatment against the predictors may result in regression of LVMI and may Improve patient outcome.