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Anemia and left ventricular hypertrophy in chronic kidney disease

Jeffrey S Berns, MD
Section Editors
Steve J Schwab, MD
Gary C Curhan, MD, ScD
Deputy Editor
Alice M Sheridan, MD


Cardiac disease, including coronary artery disease, left ventricular hypertrophy (LVH) and heart failure (HF), is common in patients with chronic kidney disease (CKD). LVH appears to be increasingly prevalent as the glomerular filtration rate (GFR) declines and with increased dialysis vintage:

LVH has been found in as many as 47 percent of patients with CKD not yet on dialysis, with a higher prevalence and more severe LVH in those with increasingly lower degrees of kidney function [1-4].

Concentric LVH has been documented by echocardiography in 42 percent of patients at the start of dialysis [5] and in as many as 75 percent of patients who have been on hemodialysis for 10 years [6].

LVH is an important predictor of mortality in patients with CKD [5,7-10]. As examples:

In a prospective study of 1249 older subjects with relatively mild CKD (mean GFR of 50 mL/min/1.73 m2), the presence of LVH was associated with an excess of 25 cardiovascular deaths/1000 patient-years [10]. This was a greater absolute risk than that associated with diabetes mellitus, smoking, and systolic hypertension.


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Literature review current through: Sep 2016. | This topic last updated: Mar 8, 2016.
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