Cardiovascular remodelling in patients with pre-dialysis chronic kidney disease and renal transplant recipients

摘要

Aim To evaluate the relationship between cardiovascular remodellingand glomerular filtration rate (eGFR) in pre-dialysis chronickidney disease (CKD) patients without cardiovascular diseases(CVD) and in renal transplant recipients (RTR).Methods The cross-sectional study included 83 patients witheGFR60 mL/min/1.73m2. All patients were evaluated by echocardiographyand X-ray.Results Left ventricular hypertrophy (LVH) was present in 74.7%CKD patients, most frequently in CKD 4 stage and in RTR. Calcificationsof abdominal aorta (CAA) were present in 87% CKD 4,60% RTR and in 44% CKD 3 patients. Calcifications of the mitralvalve were found in 34.2% CKD 4, 25.0% RTR and in 6.7% CKD3 stage patients. Aortic valve calcifications were most frequentlypresent in CKD 4 stage (26.3%). The LV mass index negativelycorrelated with eGFR (p0.001), and positively with parathyroidhormone (p0.001), phosphorus (p=0.043), age (p0.001) anddiabetes (p=0.043). In multivariate regression analysis the riskfactor for calcifications of the mitral and aortic valve, as well asfor CAA was the decline in eGFR (p0.001).Conclusion Renal transplant recipients have a higher incidenceof CV remodelling than patients with CKD 3 and less than patientswith CKD 4 stage, indicating incomplete regression of CVcalcifications and LVH after kidney transplantation. A decrease ofrenal function represents a significant risk factor for valvular andvascular calcifications occurrence in CKD patients.