The functions and geometry of the left ventricle in patients with chronic glomerulonephritis

Abstract

Aim. To study the functions and the geometry of the left ventricle in patients with chronic glomerulonephritis at different stages of chronic kidney disease, depending on the presence of arterial hypertension and dyslipidemia. Methods. Observed were 156 patients with chronic glomerulonephritis (80 men and 76 women, mean age 40.23±1.1 years), including 91 people with arterial hypertension (observation group), 65 patients without arterial hypertension (comparison group). The observation and comparison groups were divided into subgroups depending on the stage of chronic kidney disease: the first subgroup - stage 1-2, the second subgroup - stage 3-4, the third subgroup - stage 5. The control group consisted of 30 healthy people. Conducted were general clinical, laboratory and instrumental investigations. Results. Left ventricular hypertrophy was formed at stage 1-2 of chronic kidney disease in 52.5% of patients with chronic glomerulonephritis with arterial hypertension, at stage 3-4 - in 69.2%, at stage 5 - in 80.0%. The dominant type of hypertrophy was concentric; with the decrease in kidney function the frequency of eccentric hypertrophy increased. In the early stages of chronic kidney disease the incidence of left ventricular dysfunction was almost similar in arterial hypertension (62.5%) and normal blood pressure (60.0%). With the decline of the kidney function in the presence of arterial hypertension the incidence of left ventricular dysfunction reached up to 84.6% at stage 3-4 and up to 88.0% - at stage 5 of chronic kidney disease. No influence of the lipid profile on the function and the geometry of the left ventricle were found. Conclusion. In patients with chronic glomerulonephritis with arterial hypertension with the decrease in kidney function increases the frequency of left ventricular hypertrophy; in the early stages of chronic kidney disease the incidence of left ventricular dysfunction is the same in patients with and without hypertension, increasing with the decline in renal function in patients with hypertension.