Left ventricular hypertrophy and calcium, phosphate related factors in chronic hemodialysis patients

Left ventricular hypertrophy (LVH) is reported to be common in chronic hemodialysis patients and also increases risk for mortality and morbidity in such patients. Effects of PTH on LVH are approved by clinical and experimental studies. Therefore, PTH control is important in LVH prevention. In some centers PTH can be measured, so we conducted a descriptive study about the relationship between Ca, P, alkaline phosphatase and LVH in chronic hemodialysis patients.

56 chronic hemodialysis patients were included in this descriptive-analytical study and followed for one year. The patients were divided into LVH group and non- LVH group by echocardiographic findings. The mean Ca, P, Alkaline Phosphatase (Alk),Ca×P product, Hb, HCT, serum Albumin were checked monthly moreover HTN frequency, hemodialysis duration, cardiac calcification and ACE in, EPO use were compared in the two groups. Relationship between these factors and LVH was evaluated using Chi-Square T.test and fisher-Exact test.

Results showed that 32 patients (57.1%) had LVH, among them 19 patients (59.4%) were male and 13 patients were (40.6%) female (P<0.05). Mean age of patients with LVH was 53.5+13.3 which had not statistically significant difference with patients without LVH (P>0.05). The mean serum levels of Ca, P, Alk P, Hb were not significantly different in both groups but mean of Ca×P product was significantly higher in the LVH group(P<0.05) (58.7±16.6 versus 47.6±18.2).

HTN control, ACE inhibitor and EPO use are important in prevention of LVH in chronic hemodialysis patients but maintenance of Ca×P product in acceptable level is another important factor for this prevention.