Hypertension, fluid overload and micro inflammation are associated with left ventricular hypertrophy in maintenance hemodialysis patients

Figures & data

Table 1. Univariate associations of LVMI with relevant clinical and laboratory parameters in HD patients.

Parameter	Mean ± SD or median (interquartile range)	Spearman correlation, ρ	p-Value
Age (years)	60.5 (53.8–70.0)	0.128	0.180
BMI (kg/m^2)	21.8 ± 3.0	0.267	0.004
Dialysis vintage (months)	53.0 (21.0–91.3)	−0.254	0.107
spKt/V	1.31 (1.17–1.58)	−0.144	0.042
Ultrafiltration volume (mL)	2500 (2000–3100)	0.117	0.233
erythropoietin dose (U/week)	10,000 (5000–10,000)	0.162	0.093
Systolic blood pressure (mmHg)	136.2 ± 22.2	0.468	<0.001
Diastolic blood pressure (mmHg)	79.3 ± 12.8	0.264	0.007
Serum albumin (g/L)	40.0 ± 3.0	−0.102	0.283
Pre-albumin (g/L)	0.34 ± 0.09	−0.243	0.009
Serum creatinine (μmol/L)	968.7 ± 250.0	−0.151	0.042
BUN (mmol/L)	24.1 (21.7–30.2)	0.065	0.495
Serum uric acid (μmol/L)	436.3 ± 93.2	−0.086	0.369
Calcium (mmol/L)	2.24 (2.12–2.40)	−0.133	0.161
Phosphorus (mmol/L)	1.99 (1.60–2.57)	0.051	0.593
Ca × P product (mmol^2/L^2)	4.42 (3.45–6.04)	0.027	0.778
iPTH (pg/ml)	338.6 (172.4–575.6)	0.142	0.135
25(OH)D3 (nmol/mL)	31.9 (19.3–40.4)	−0.137	0.154
Total cholesterol (mmol/L)	4.46 ± 1.03	−0.017	0.862
Triglyceride (mmol/L)	1.38 (1.04–1.96)	−0.046	0.628
HDL-C (mmol/L)	1.12 ± 0.35	−0.023	0.811
LDL-C (mmol/L)	2.54 ± 0.94	−0.018	0.848
non-HDL (mmol/L)	3.30 ± 1.01	0.027	0.789
β2-Microglobulin (mg/L)	30.2 (18.6–36.2)	0.031	0.746
Blood glucose (mmol/L)	6.1 (4.9–8.2)	0.142	0.135
Glycosylated hemoglobin (%)	5.2 (4.9–5.8)	0.214	0.025
Glycated albumin (%)	14.5 (13.2–16.2)	0.206	0.031
Hemoglobin (g/L)	110.1 ± 14.1	−0.008	0.929
White blood cell count (10^9/L)	5.91 (5.00–7.00)	0.034	0.722
Transferrin (g/L)	1.85 (1.69–2.09)	−0.112	0.248
Ferritin (ng/mL)	168.1 (86.8–321.0)	0.017	0.857
Homocysteine (μmol/L)	30.9 (26.0–38.3)	0.076	0.440
Hs-CRP (mg/L)	3.5 (1.3–10.4)	0.323	0.001
cTnT (ng/mL)	0.046 (0.031–0.065)	0.301	0.002
NT-proBNP (pg/mL)	4168.0 (1975.5–12,570.5)	0.476	<0.001
cIMT (cm)	0.8 (0.7–0.8)	0.267	0.015
LVEF (%)	64 (61–69)	−0.285	0.002
Fractional shortening (%)	36 (32–39)	−0.211	0.026

Note: BMI, body mass index; spKt/V, single pool urea clearance index; BUN, blood urea nitrogen; iPTH, intact-parathyroid hormone; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; cTnT, cardiac troponin T; NT-proBNP, amino-terminal pro-B-natriuretic peptide; hs-CRP, high-sensitive C-reactive protein; cIMT, carotid artery intima-media thickness and LVEF, left ventricular ejection fraction.

Table 2. Linear regression analysis of associations between LVMI and laboratory parameters.

Independent variables	Unstandardized β-coefficient	Standardized β-coefficient	p-Value
Systolic blood pressure	0.007	0.432	<0.001
NT-proBNP	0.219	0.316	0.001
LVEF	−0.009	−0.175	0.038

Table 3. Patients characteristics and laboratory parameters in LVH and non-LVH patients.

	Non-LVH (N = 60)	LVH (N = 52)	p-Value
Gender (male/female)	36/24	21/31	0.058
Age (years)	60.0 (53.0–66.0)	66.0 (57.3–73.8)	0.033
Smoker (yes/no)	20/40	9/43	0.083
Diabetes (yes/no)	10/50	11/41	0.629
Dialysis vintage (months)	61 (28–95)	37 (11–82)	0.094
BMI (kg/m^2)	21.5 ± 2.9	22.7 ± 3.0	0.039
SpKt/V	1.32 (1.21–1.56)	1.31 (1.16–1.55)	0.102
Ultrafiltration volume (mL)	2500 (2000–3000)	2350 (1800–3200)	0.535
Erythropoietin dose (U/week)	10,000 (5000–10,000)	10,000 (5500–10,000)	0.654
Systolic blood pressure (mmHg)	127.8 ± 18.7	145.8 ± 23.0	<0.001
Diastolic blood pressure (mmHg)	76.5 ± 10.5	81.2 ± 14.6	0.072
Serum albumin (g/L)	40.3 ± 2.8	39.7 ± 3.1	0.315
Pre-albumin (g/L)	0.35 ± 0.09	0.34 ± 0.09	0.406
Serum creatinine (μmol/L)	1011.6 ± 273.0	919.9 ± 189.5	0.035
BUN (mmol/L)	25.5 ± 7.0	25.1 ± 5.0	0.753
Serum uric acid (μmol/L)	447.1 ± 103.3	424.2 ± 79.6	0.198
Calcium (mmol/L)	2.23 ± 0.29	2.27 ± 0.25	0.391
Phosphorus (mmol/L)	1.97 ± 0.74	2.15 ± 0.68	0.173
Ca × P product (mmol^2/L^2)	4.68 ± 1.92	4.79 ± 1.63	0.757
iPTH (pg/mL)	256.4 (153.1–566.2)	367.6 (207.5–617.2)	0.124
25(OH)D3 (nmol/mL)	34.4 (20.6–46.3)	29.5 (18.2–36.8)	0.065
Triglyceride (mmol/L)	1.37 (0.99–1.99)	1.41 (1.07–2.01)	0.521
Total cholesterol (mmol/L)	4.35 ± 0.97	4.56 ± 1.06	0.291
LDL (mmol/L)	2.50 ± 0.95	2.55 ± 0.89	0.778
HDL (mmol/L)	1.13 ± 0.33	1.17 ± 0.36	0.557
non-HDL (mmol/L)	3.23 ± 0.98	3.39 ± 1.05	0.409
β2-microglobulin (mg/L)	28.4 (18.6–36.4)	30.0 (18.7–35.9)	0.935
Blood glucose (mmol/L)	5.9 (5.1–7.4)	6.6 (4.7–9.5)	0.156
Glycosylated hemoglobin (%)	5.2 (4.9–5.6)	5.4 (5.0–6.0)	0.182
Glycated albumin (%)	14.2 (13.0–16.0)	15.0 (13.6–16.7)	0.093
Hemoglobin (g/L)	110.0 ± 13.9	110.2 ± 14.2	0.926
White blood cell count (10^9/L)	5.89 ± 1.87	6.20 ± 2.03	0.419
Transferrin (g/L)	1.95 ± 0.37	1.88 ± 0.38	0.310
Ferritin (ng/mL)	172.6 (88.2–310.5)	138.2 (84.9–321.1)	0.584
Homocysteine	30.9 (26.6–36.9)	31.2 (26.4–41.0)	0.473
Hs-CRP (mg/L)	2.2 (0.8–7.8)	4.6 (1.8–16.6)	0.004
cTnT (ng/mL)	0.044 (0.024–0.064)	0.051 (0.031–0.071)	0.117
NT-proBNP (pg/mL)	2850.0 (1446.5–5212.0)	7579.0 (2933.0–13,970.5)	0.001
cIMT (cm)	0.7 (0.6–0.8)	0.8 (0.7–0.9)	0.013
LVEF (%)	67 (62–70)	65 (61–69)	0.053
Fractional shortening (%)	37 (32–40)	35 (32–39)	0.154
LVMI (g/m^2.7)	39.3 ± 7.1	59.2 (53.0–66.1)	<0.001

Table 4. Binary logistic regression analysis of independent risk factors of LVH.

	OR	95% CI	p-Value
Systolic blood pressure (1 mmHg increment)	1.037	1.006–1.069	0.019
NT-proBNP > 4168.0 (pg/mL)	4.698	1.596–13.829	0.005
Hs-CRP > 3.5 (mg/L)	2.496	1.186–11.027	0.043

Figure 1. Receiver operator characteristic curves versus LVH generated with NT-proBNP, hs-CRP and cTnT.