Left Ventricular Hypertrophy in Patients with Chronic Kidney Disease

Abstract

Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias, and sudden cardiac death represent main causes of morbidity and mortality in patients with chronic kidney disease (CKD). Their pathogenesis relates to the close linkage between heart and kidneys and involves both traditional and non-traditional risk factors. According to the well-established classification of cardio-renal syndrome, the cardiovascular involvement in chronic kidney disease is known as “type 4 cardiorenal syndrome” (chronic renocardiac syndrome). Uremic cardiopathy is mainly characterized by both left ventricular systolic and diastolic impairment, often associated to right heart dysfunction due to the presence of a vascular access for hemodialysis. The typical clinical picture is represented by left ventricular hypertrophy (LVH), the pathogenesis of which is multifactorial and closely linked to elevated blood pressure, vascular stiffness and atherosclerosis. The diagnosis is mainly made by ultrasound (2D and 3D echocardiography) and cardiac magnetic resonance imaging (CMRI), although echocardiography is most widely employed since it is non-invasive and cheaper than CMRI. The following chapter provides an overview of the epidemiology, pathophysiology, diagnosis, and treatment of left ventricular hypertrophy in CKD patients. (Cardionephrology)