Relationship between arterial pressure indexes and structura-functional condition of myocardium in patients with stage 5d chronic kidney disease

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Abstract

Arterial hypertension (AH) is one of the risk factors for the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD).

The aim of the research is to evaluate the parameters of ABPM in patients receiving treatment with program hemodialysis, depending on the structural and functional heart condition.

Material and methods. 179 patients with stage 5d CKD (79 males and 100 females) were examined. Average age of participants was 56,9±12,2 years, their dialysis experience was 5,7±3,5 years. All patients underwent ABPM and Echo-KG examination.

Results. In examined patients, circadian rhythms of BP of the Non-dipper and Night Peaker types were revealed in SBP (81,6%; p <0,001) and DBP (73,2%; p <0,001). A correlation was fixed between the degree of nighttime decrease in SBP and DBP with LVM (r=-0,45, p <0,01; r=-0,51, p <0,01), LVMI (r=-0,55, p <0,001; r=-0,53, p <0,01). Pulse wave velocity was associated with interdialysis weight gain (r=0,55, p<0,001) and medium fibers shortening fraction (r=0,4, p<0,05). In 116 (64,8%) patients, a moderate increase in arterial stiffness index (p <0,001) was observed, which correlated with LVM (r=0.34, p<0.05) and SBP (r=0.39, p <0,05). In 135 (75,4%) patients with CKD, parasympathicotonia predominated (p <0,001). A correlation was found between the vegetative index and LVMI (r=-0,51, p<0,001) and LVMI (r=-0,44, p<0,01).

Conclusion. Most patients with stage 5d CKD have predominating parasympathicotonia, which is associated with LVMI. Moderate increase in arterial stiffness index, correlating with interdialytic weight gain takes place. BP circadian rhythm disturbance was associated with LVMI, DBP level correlated with right ventricular thickness.

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About the authors

Evgeny N. Ievlev

Izhevsk State Medical Academy of the Ministry of Healthcare of Russia; City Clinical Hospital No. 6 of the Ministry of Healthcare of the Udmurt Republic

Author for correspondence.
Email: inloja@mail.ru
ORCID iD: 0000-0002-0395-7946

PhD in Medical Sciences, Associate Professor of the Department of Internal Diseases with Courses in Radiation Methods of Diagnosis and Treatment, Military Field Therapy, Izhevsk State Medical Academy of the Ministry of Healthcare of Russia, General Practitioner of the Admissions Department of City Clinical Hospital No. 6 of the Ministry of Healthcare of the Udmurt Republic

Russian Federation, Izhevsk; Izhevsk

Irina A. Kazakova

Izhevsk State Medical Academy of the Ministry of Healthcare of Russia

Email: i.a.kazakova@yandex.ru
ORCID iD: 0000-0001-7815-1536

MD, Professor, Head of the Department of Internal Diseases with Courses in Radiation Methods of Diagnosis and Treatment, Military Field Therapy

Russian Federation, Izhevsk

References

  1. Ashby D., Borman N., Burton J. et al. Renal association clinical practice guideline on haemodialysis. BMC Nephrol. 2019; 20(1): 379. https://dx.doi.org/10.1186/s12882-019-1527-3.
  2. Vareta G., Georgianos P.I., Vaios V. et al. Prevalence of apparent treatment-resistant hypertension in ESKD patients receiving peritoneal dialysis. Am J Hypertens. 2022; 35(11): 918–22. https://dx.doi.org/10.1093/ajh/hpac086.
  3. Liu S., Liao Y., Zhu Z. et al. Association between cumulative blood pressure in early adulthood and right ventricular structure and function in middle age: The CARDIA study. Clin Cardiol. 2022; 45(1): 83–90. https://dx.doi.org/10.1002/clc.23763.
  4. Cai R., Shao L., Zhu Y. et al. Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease. Nephrology (Carlton). 2022; 27(1): 57–65. https://dx.doi.org/10.1111/nep.13967.
  5. Leibowitz D. Left ventricular hypertrophy and chronic renal insufficiency in the elderly. Cardiorenal Med. 2014; 4(3–4): 168–75. https://dx.doi.org/10.1159/000366455.
  6. Di Lullo L., Gorini A., Russo D. et al. Left ventricular hypertrophy in chronic kidney disease patients: From pathophysiology to treatment. Cardiorenal Med. 2015; 5(4): 254–66. https://dx.doi.org/10.1159/000435838.
  7. Sun L., Li Q., Sun Z. et al. Impact of overhydration on left ventricular hypertrophy in patients with chronic kidney disease. Front Nutr. 2022; 9: 761848. https://dx.doi.org/10.3389/fnut.2022.761848.
  8. Schneider M.P., Scheppach J.B., Raff U. et al. Left ventricular structure in patients with mild-to-moderate CKD – a Magnetic Resonance Imaging Study. Kidney Int Rep. 2018; 4(2): 267–74. https://dx.doi.org/10.1016/j.ekir.2018.10.004.
  9. Kupferman J.C., Aronson Friedman L., Cox C. et al.; CKiD Study Group. BP control and left ventricular hypertrophy regression in children with CKD. J Am Soc Nephrol. 2014; 25(1): 167–74. https://dx.doi.org/10.1681/ASN.2012121197.
  10. Fu X., Ren H., Xie J. et al. Association of nighttime masked uncontrolled hypertension with left ventricular hypertrophy and kidney function among patients with chronic kidney disease not receiving dialysis. JAMA Netw Open. 2022; 5(5): e2214460. https://dx.doi.org/10.1001/jamanetworkopen.2022.14460.
  11. Fujii H., Watanabe S., Kono K. et al. One-year impact of kidney transplantation on cardiac abnormalities and blood pressure in hemodialysis patients. Ther Apher Dial. 2019; 23(6): 529–33. https://dx.doi.org/10.1111/1744-9987.12808.
  12. Cha R.H., Lee H., Lee J.P. et al. Changes of blood pressure patterns and target organ damage in patients with chronic kidney disease: Results of the APrODiTe-2 study. J Hypertens. 2017; 35(3): 593–601. https://dx.doi.org/10.1097/HJH.0000000000001185.
  13. Kang E., Lee J., Kim H.J. et al. The association between socioeconomic disparities and left ventricular hypertrophy in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD). BMC Nephrol. 2018; 19(1): 203. https://dx.doi.org/10.1186/s12882-018-1005-3. Erratum in: BMC Nephrol. 2018; 19(1): 217.
  14. Che X., Mou S., Zhang W. et al. The impact of non-dipper circadian rhythm of blood pressure on left ventricular hypertrophy in patients with non-dialysis chronic kidney disease. Acta Cardiol. 2017; 72(2): 149–55. https://dx.doi.org/10.1080/00015385.2017.1291133.
  15. Kim I.Y., Ye B.M., Kim M.J. et al. Association between serum uric acid and left ventricular hypertrophy/left ventricular diastolic dysfunction in patients with chronic kidney disease. PLoS One. 2021; 16(5): e0251333. https://dx.doi.org/10.1371/journal.pone.0251333.
  16. Chen H., Watnick T., Hong S.N. et al. Left ventricular hypertrophy in a contemporary cohort of autosomal dominant polycystic kidney disease patients. BMC Nephrol. 2019; 20(1): 386. https://dx.doi.org/10.1186/s12882-019-1555-z.
  17. Schneider M.P., Raff U., Kopp C. et al. Skin sodium concentration correlates with left ventricular hypertrophy in CKD. J Am Soc Nephrol. 2017; 28(6): 1867–76. https://dx.doi.org/10.1681/ASN.2016060662.
  18. Nitta K., Iimuro S., Imai E. et al. Risk factors for increased left ventricular hypertrophy in patients with chronic kidney disease: Findings from the CKD-JAC study. Clin Exp Nephrol. 2019; 23(1): 85–98. https://dx.doi.org/10.1007/s10157-018-1605-z. Erratum in: Clin Exp Nephrol. 2019; 23(1): 99.

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2. Fig. Characteristics of the daily rhythm of arterial pressure in the studied patients with chronic kidney disease stage 5d

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