대한신장학회

논문분류	춘계학술대회 초록집
제목	Left ventricular hypertrophy associated factors in hemodialysis patients
저자	Jung Hwan Park1, Chae Ho Lim* 1, Hyun Suk Yang2, Young-Il Jo1, Jong Ho Lee1
출판정보	2016; 2016(1):
키워드	bioimpedance, left ventricular hypertrophy
초록	Background: Left ventricular hypertrophy (LVH) is highly prevalent in patients with end-stage renal disease. LVH is an independent predictor of cardiovascular mortality in the patients. We investigated which elements of hemodialysis (HD) are associated with LVH. Methods: We performed a cross-sectional study on maintenance HD patients at the dialysis unit of Konkuk University Hospital. Inclusion criteria were age >15, and maintenance HD for more than a month. Left ventricular mass index (LVMI) was measured by echocardiography. LVH was defined as LVMI >125 g/m2 in male patients and >110 g/m2 in female patients. Multi-frequency bioimpedance analysis was done before, hourly during HD, and after the HD session. Blood pressure (BP) was measured at the same time. Correlation analysis utilized the Spearman’s Rank Correlation coefficient. Results: The mean age of the subjects was 61.7 ± 15.9 (range, 23-87 yr). The dialysis vintage was 67.7 ± 51.5 months. Among the 47 subjects, 55.3% were female. Underlying diseases were DM (48.9%), hypertension (36.2%), chronic glomerular nephritis (10.6%) and unknown (4.3%). The median value of LVMI was 118.5 g/m2 (range, 64–239). LVH was detected in 28 patients. The BP of 16 patients went up during HD. There were no significant differences between the patients with or without LVH for age, gender, dialysis vintage, weight, BMI, body surface area (BSA), total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/TBW, ultrafiltration volume, and BP. However, for ECW per body weight (ECWbody weight, L/kg, p=0.068) and ECW per BSA (ECWBSA, L/m2, p=0.066), the differences were marginally significant. LVH was more common in patients with BP rising during HD. A positive correlation was noted between LVMI and ECW (r=0.354, p<0.05), TBW (r=0.349, p<0.05), ICW (r=0.297, p<0.05), ECWbody weight (r=0.370, p<0.05) and ECWBSA (r=0.485, p<0.01). By multivariate logistic regression analysis, risk factors for LVH was BP rising during HD (OR 5.9 (1.18-29.3), p<0.05, adjusted for systolic BP). Conclusion: We found an association between LVH in HD patients and corrected ECW by BSA or body weight and BP rising during HD.
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