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Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation.
Ethn Dis. 2006 Autumn; 16(4):859-64.ED

Abstract

OBJECTIVE

Chronic kidney disease (CKD) is a major cause of cardiovascular morbidity and mortality all over the world. The combined effect of volume and pressure overload seen in patients with CKD is the primary cause of left ventricular hypertrophy (LVH). Though it accounts for a significant proportion of patients dying in hospitals in Nigeria, information on CKD in African Blacks is lacking. This study evaluates the prevalence of LVH and factors affecting it in pre-dialysis patients by using echocardiography.

DESIGN, SETTING AND PATIENTS

One hundred consecutive patients with CKD who were attending the medical outpatient and renal clinics of University of Nigeria Teaching Hospital, Enugu, who satisfied the inclusion criteria were screened for the study. Eighty-eight patients completed the study. Forty-five age- and sex-matched subjects were selected as controls. Clinical and laboratory parameters and echocardiographic indices were measured.

RESULTS

Left ventricular hypertrophy (LVH), defined in absolute terms as left ventricular mass index >134 g/m2 in men and >110 g/m2 in women was present in 95.5% of patients and 6.7% of controls. The most prevalent type of LVH was eccentric hypertrophy, which was found in 54.6%, while concentric was seen in 40.9%. Hypertension was present in 85.2% of the patients. The predominant causes of CKD were chronic glomerulonephritis (43.2%), hypertension (25%), and diabetes mellitus (14.8%). All the patients studied had advanced CKD, either stage 4 or 5 of the Kidney Disease Outcome Quality Initiative classification of CKD. Stepwise method of multiple linear regressions identified mean arterial pressure (32%), hemoglobin concentration (22%), male sex (17%), and creatinine clearance (24%) as predictors of LVH in CKD.

CONCLUSION

This study showed a strong association between CKD and LVH in patients in developing countries at the time of first evaluation by a nephrologist. It demonstrated a high prevalence of LVH in patients at first evaluation. The patients were often anemic and had severe hypertension even at first presentation. Early detection and treatment of causes of CKD should be pursued aggressively at the primary prevention level, as has been advocated by the International Society of Nephrology to reduce the effects of CKD and its attendant complications in the society.

Authors+Show Affiliations

Renal Unit, Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria. ifeomaulasi@yahoo.co.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17061738

Citation

Ulasi, Ifeoma I., et al. "Left Ventricular Hypertrophy in African Black Patients With Chronic Renal Failure at First Evaluation." Ethnicity & Disease, vol. 16, no. 4, 2006, pp. 859-64.
Ulasi II, Arodiwe EB, Ijoma CK. Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. Ethn Dis. 2006;16(4):859-64.
Ulasi, I. I., Arodiwe, E. B., & Ijoma, C. K. (2006). Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. Ethnicity & Disease, 16(4), 859-64.
Ulasi II, Arodiwe EB, Ijoma CK. Left Ventricular Hypertrophy in African Black Patients With Chronic Renal Failure at First Evaluation. Ethn Dis. 2006;16(4):859-64. PubMed PMID: 17061738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. AU - Ulasi,Ifeoma I, AU - Arodiwe,Ejikeme B, AU - Ijoma,Chinwuba K, PY - 2006/10/26/pubmed PY - 2007/7/12/medline PY - 2006/10/26/entrez SP - 859 EP - 64 JF - Ethnicity & disease JO - Ethn Dis VL - 16 IS - 4 N2 - OBJECTIVE: Chronic kidney disease (CKD) is a major cause of cardiovascular morbidity and mortality all over the world. The combined effect of volume and pressure overload seen in patients with CKD is the primary cause of left ventricular hypertrophy (LVH). Though it accounts for a significant proportion of patients dying in hospitals in Nigeria, information on CKD in African Blacks is lacking. This study evaluates the prevalence of LVH and factors affecting it in pre-dialysis patients by using echocardiography. DESIGN, SETTING AND PATIENTS: One hundred consecutive patients with CKD who were attending the medical outpatient and renal clinics of University of Nigeria Teaching Hospital, Enugu, who satisfied the inclusion criteria were screened for the study. Eighty-eight patients completed the study. Forty-five age- and sex-matched subjects were selected as controls. Clinical and laboratory parameters and echocardiographic indices were measured. RESULTS: Left ventricular hypertrophy (LVH), defined in absolute terms as left ventricular mass index >134 g/m2 in men and >110 g/m2 in women was present in 95.5% of patients and 6.7% of controls. The most prevalent type of LVH was eccentric hypertrophy, which was found in 54.6%, while concentric was seen in 40.9%. Hypertension was present in 85.2% of the patients. The predominant causes of CKD were chronic glomerulonephritis (43.2%), hypertension (25%), and diabetes mellitus (14.8%). All the patients studied had advanced CKD, either stage 4 or 5 of the Kidney Disease Outcome Quality Initiative classification of CKD. Stepwise method of multiple linear regressions identified mean arterial pressure (32%), hemoglobin concentration (22%), male sex (17%), and creatinine clearance (24%) as predictors of LVH in CKD. CONCLUSION: This study showed a strong association between CKD and LVH in patients in developing countries at the time of first evaluation by a nephrologist. It demonstrated a high prevalence of LVH in patients at first evaluation. The patients were often anemic and had severe hypertension even at first presentation. Early detection and treatment of causes of CKD should be pursued aggressively at the primary prevention level, as has been advocated by the International Society of Nephrology to reduce the effects of CKD and its attendant complications in the society. SN - 1049-510X UR - https://www.unboundmedicine.com/medline/citation/17061738/Left_ventricular_hypertrophy_in_African_Black_patients_with_chronic_renal_failure_at_first_evaluation_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -