Effect of anaemia on left ventricular hypertrophy in end-stage renal disease

Locatelli, Francesco; Pozzoni, Pietro; Del Vecchio, Lucia; Tentori, Francesca
June 2003
European Journal of Heart Failure. Supplements;Jun2003, Vol. 2 Issue 2, p207
Academic Journal
Cardiovascular disease (CVD) is highly prevalent among end-stage renal disease (ESRD) patients and is the main reason for their high mortality and morbidity rates. The large proportion of patients starting renal replacement therapy who also have CVD, suggests that pathogenetic factors leading to cardiac dysfunction begin in the early stages of chronic kidney disease (CKD). Anaemia may be an important pathogenetic factor responsible for cardiovascular abnormalities, in particular left ventricular hypertrophy (LVH), which significantly worsens the prognosis of CKD patients. This would account for the association between anaemia and both hospitalisation and mortality rates in such patients and leads to the expectation that correction of anaemia will improve cardiovascular status and long-term prognosis. A partial regression of LVH after a partial correction of anaemia has been observed in several studies, but it is still unclear whether normalizing haemoglobin concentrations produces additional cardiac advantages. Indeed, no significant differences between partial and complete correction of anaemia in inducing regression of established LVH have been demonstrated so far, but further investigation is needed. Furthermore, normalization of anaemia improves quality of life and physical function of selected categories of patients. Also keeping in mind the potential risks of haemoglobin normalization in haemodialysis patients with severe heart disease and grafts, individualising the target haemoglobin concentration to the characteristics of the patients is probably one of the winning strategies in the modern management of renal anaemia.


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