Anemia and Structural and Functional Heart Conditions in Patients Undergoing Renal Replacement Therapy

Abstract

Anemia is one of the modifiable risk factors for the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). However, there are not enough studies on the effect of iron metabolism on left ventricular geometry.
 Materials and Methods. The authors examined 147 patients (69 males and 78 females) with CKD undergoing long-term hemodialysis. The mean age was 55.6±13.4 years. Median dialysis treatment was
 3 [2; 5] years. Kt/V index was 1.52±0.2. Based on the echocardiogram data, we calculated left ventricular mass (LVM), left ventricular mass index (LVMI), relative wall thickness index (RWTI), intima, and medium fiber fractional shortening. Ferritin, transferrin, and transferrin saturation were also determined.
 Results. Changes in LV geometry were detected in 124 (84.4 %) patients. Higher LVMI, and RWTI parameters were observed in the group of patients with hemoglobin <100 g/l. Patients with ferritin levels >800 ng/l demonstrated higher end-systolic dimension and lower left ventricular ejection fraction compared to patients with ferritin levels <500 ng/mL.
 Conclusion. Structural and functional indicators of the heart in patients undergoing long-term hemodialysis correlate not only with hemoglobin level, but also with indicators of iron metabolism (ferritin, transferrin, and transferrin saturation). In patients with a high ferritin level, left ventricle functional parameters are lower.