Left ventricular hypertrophy and geometry in hypertensive patients with chronic kidney disease

J Hypertens. 2009 Mar;27(3):633-41. doi: 10.1097/HJH.0b013e3283220ecd.


Objective: To evaluate the prevalence of left ventricular hypertrophy (LVH) and left ventricular geometry in a group of 293 hypertensive patients with stage 2-5 chronic kidney disease (CKD), compared with 289 essential hypertensive patients with normal renal function.

Methods: All patients underwent echocardiographic examination. Patients on stage 1 CKD, dialysis treatment, or with cardiovascular diseases were excluded.

Results: LVH was observed in 47.1% of patients with CKD and in 31.14% of essential hypertensive patients (P < 0.0001). We found increasingly higher left ventricular diameters, thicknesses, and mass from stage 2 to 5 CKD. Distribution of concentric and eccentric LVH was not different between the two groups. However, after introducing mixed hypertrophy, the difference between the two groups group was disclosed (P = 0.027). The prevalence of inappropriate left ventricular mass was 52.6% in patients with CKD vs. 30.5% in essential hypertensive patients (P < 0.0001). Multiple regression analysis confirmed that the association between renal function and left ventricular mass (beta -0.287; P < 0.0001) was independent by potential confounders. From stage 4 to 5, the significant increase of left ventricular mass was due to growth in posterior wall thickness rather than end-diastolic diameter. Diastolic function was significantly worse in patients with CKD, especially in more advanced stages.

Conclusion: Our study confirms that LVH is highly prevalent in patients with CKD; in this population, LVH is often inappropriate and characterized by the simultaneous increase of wall thicknesses and diameters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aldosterone / metabolism
  • Blood Pressure Determination / methods
  • Case-Control Studies
  • Catecholamines / blood
  • Chronic Disease
  • Creatinine / blood
  • Diabetes Mellitus / epidemiology
  • Echocardiography, Doppler
  • Electrolytes / blood
  • Electrolytes / urine
  • Female
  • Glomerular Filtration Rate
  • Guidelines as Topic
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / epidemiology*
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology*
  • Hypertrophy, Left Ventricular / etiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Italy
  • Kidney Diseases / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Renin / metabolism


  • Catecholamines
  • Electrolytes
  • Aldosterone
  • Creatinine
  • Renin