Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure

Tucker, Beatriz; Fabbian, Fabio; Giles, M.; Thuraisingham, Raj; Raine, A. E. G.; Baker, L. R. I.

doi:10.1093/ndt/12.4.724

Cited by 120 publications

(69 citation statements)

References 3 publications

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“…Some data suggest that mean 24-hour blood pressure is a better predictor of increased LVM than office blood pressure in adults with CRI. 23 In contrast to the CRI group, we were able to show strong relationships of both LVEDD (preload) and indexed SBP or DBP (afterload) to LVM index in the group undergoing dialysis. These results are not surprising, because most of the dialysis children were hypertensive and were undergoing chronic hemodialysis, with two thirds of them having a-v shunting as a result of their graft.…”

Section: Mechanisms Of Increased Lvm In Children With Chronic Renal Dcontrasting

confidence: 67%

Left Ventricular Mass and Systolic Performance in Pediatric Patients With Chronic Renal Failure

Mitsnefes

Kimball²,

Witt³

et al. 2003

Circulation

141

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Background-Children with chronic renal disease have a high prevalence of left ventricular hypertrophy (LVH), which is thought to be adaptive to improve contractility and lower wall stress in the face of increased afterload and preload. The aim of this study was to determine the association between LV mass, LV performance, and LV contractility in children with chronic renal insufficiency (CRI) and children undergoing chronic dialysis. Methods and Results-Twenty-five children with CRI, 12 undergoing chronic dialysis, and 24 controls had echocardiographic evaluation during rest and peak exercise. LV performance was assessed by calculation of shortening fraction and heart rate-corrected velocity of circumferential fiber shortening (VCF). Contractility (VCF difference) was determined based on the relation between VCF and end-systolic wall stress. Contractile reserve was assessed by the difference between contractility at rest and peak exercise.

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Section: Mechanisms Of Increased Lvm In Children With Chronic Renal Dcontrasting

confidence: 67%

Left Ventricular Mass and Systolic Performance in Pediatric Patients With Chronic Renal Failure

Mitsnefes

Kimball²,

Witt³

et al. 2003

Circulation

141

View full text Add to dashboard Cite

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“…This is true for markers of kidney damage, such as proteinuria, wherein a cross-sectional study of 232 CKD patients found ABPM is more strongly associated with proteinuria than was clinic BP. 17 ABPM is also more strongly associated with echocardiographic left ventricular hypertrophy than is clinic BP, as shown in studies of disparate CKD populations such as (i) a study of 85 CKD patients without diabetes or history of cardiovascular disease, 18 (ii) in a study of 26 normotensive patients with polycystic kidney disease, 19 (iii) and in 599 CKD patients from the AASK cohort study. 20 …”

Section: End Organ Damagementioning

confidence: 92%

The Complex Relationship Between CKD and Ambulatory Blood Pressure Patterns

Sinha

Agarwal

2015

Advances in Chronic Kidney Disease

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Hypertension and chronic kidney disease (CKD) frequently coexist, and both are risk factors for cardiovascular events and mortality. Among people with hypertension, the loss of the normal fall in nighttime BP, called nondipping, can only be diagnosed by ambulatory BP monitoring (ABPM), and is a risk factor for cardiovascular events. The pathophysiology of nondipping is complex, and CKD is an independent risk factor for non-dipping. In fact, non-dipping can be seen in as many as 80% of people with CKD. However, the evidence for nondipping as an independent risk factor or causal agent for adverse outcomes in CKD remains mixed. ABPM has been shown to be superior to clinic BP measurement for correlating with end organ damage and prognosis in CKD. This review covers the evidence for the use of ABPM in CKD, the evidence linking ABPM patterns to outcome in CKD, and the evidence for treatment of nondipping in CKD.

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“…Ambulatory blood pressure monitoring (ABPM) may be more informative about the severity of BP elevation than clinic measurements in renal failure and following renal transplantation. 9,10 Additionally, the possibility of noninvasive measurement of BP at night and during sleep by ambulatory monitoring devices has stimulated interest in the pathophysiological significance of night-time BP. Blood pressure at night was reported to be independently associated with end-organ damage above the risk associated with daytime values.…”

Section: Introductionmentioning

confidence: 99%

Night-time blood pressure load is associated with higher left ventricular mass index in renal transplant recipients

et al. 2003

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The absence of nocturnal fall in blood pressure (BP) is named as nondipper status, which has been shown to be an additional risk factor for the development of left ventricular hypertrophy and cardiovascular events in several high-risk groups. The aim of this study was to determine the influences of the nondipper status and nocturnal blood pressure loads on left ventricular mass index (LVMI) in renal transplant recipients. A total of 35 nondiabetic renal transplant recipients were included into the study. A 24-h ambulatory blood pressure monitoring (ABPM) was performed for all recipients. The nondipper status was defined as either an increase in night-time mean arterial pressure (MAP) or a decrease of no more than 10% of daytime MAP. LVMI was measured by using two-dimensional guided M-mode echocardiography. The night-time systolic blood pressure (SBP) load was defined as the percentage of the time, during which SBP exceeded 125 mmHg during night time. The nondipping was common among renal transplant recipients, of whom 60% were nondipper in our study. LVMI was significantly higher in the nondipper group vs the dipper group (133 7 35 g/m 2 vs 109 7 26 g/m 2 , P ¼ 0.04). A fall in MAP at night time was 14.5 7 4.3% in the dipper group, while it was 1.4 7 6.1% in the nondipper group (Po0.001). On stepwise multiple regression analysis, night-time SBP load and haemoglobin were independent predictors of LVMI (R 2 ¼ 0.53).In conclusion, nondipping is common after renal transplantation. Night-time SBP load and low haemoglobin are closely related to the increase in LVMI in renal transplant recipients. ABPM may be a more useful tool in optimizing treatment strategies to reduce cardiovascular events in renal transplant recipients.

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Left ventricular hypertrophy and ambulatory blood pressure monitoring in chronic renal failure

Abstract: Twenty-four hour ambulatory BP recording and echocardiography are required for accurate diagnosis of inadequate BP control and early LVH in patients with chronic renal impairment, independent determinants of which are hypertension, male sex, BMI, and anaemia.

Cited by 120 publications

References 3 publications

Left Ventricular Mass and Systolic Performance in Pediatric Patients With Chronic Renal Failure

Left Ventricular Mass and Systolic Performance in Pediatric Patients With Chronic Renal Failure

The Complex Relationship Between CKD and Ambulatory Blood Pressure Patterns

Night-time blood pressure load is associated with higher left ventricular mass index in renal transplant recipients

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