Hypertriglyceridemia and Remodeling of the Left Ventricle in Patients with Chronic Kidney Disease

IT Murkamilov^1,2, IS Sabirov², KA Aitbaev³, VV Fomin⁴, Zh A Murkamilova⁵, ZR Rayimzhanov^1,6, NA Redjapova⁷ and FA Yusupov⁷

Received: November 28, 2018;   Published: December 19, 2018

DOI: 10.32474/JUNS.2018.01.000115

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Abstract

Aim: The aim of the study was to study the clinical and functional features of renal dysfunction in conditions of hypertriglyceridemia and remodeling of the left ventricle.

Materials and Methods: 176 patients with chronic kidney disease (CKD) were examined, 111 of them with hypertriglyceridemia (HTG) in association with left ventricular hypertrophy (LVH) 1st group and 65 patients with LVH in the absence of HTG, matched by gender and age. Along with general clinical studies, all patients were assessed for lipid spectrum parameters, measurement of cystatin C in blood plasma, and indicators of arterial stiffness (augmentation index and stiffness) and echocardiography were analyzed.

Results: In the 2^nd group (HTG + LVH), the number of patients with type 2 diabetes mellitus (DM), a combination of hypertension, coronary heart disease and gout were significantly higher (p<0.05). Persons with chronic obstructive pulmonary disease, chronic pyelonephritis and cerebrovascular diseases were significantly more common in the 1st group (p <0.05). In the 2^nd group, the value of BMI [(30.4 ± 5.2 kg/m² against 28.1±5.7 kg /m²; p = 0.013), the level of systolic blood pressure (BP) (140 ± 19 mm Hg). v. 134 ± 18 mmHg; p = 0.042), thickness of the posterior wall of the left ventricle (LV) (0.98 ± 0.18 cm versus 0.90 ± 0.16 cm; p = 0.008), relative thickness LV walls (0.385 ± 0.107 units versus 0.357 ± 0.060 units; p=0.032), the number of patients with concentric LV hypertrophy (29.2; versus 13.5%; p=0.008), total cholesterol content (5.80 (4.87;6.80) mmol/l vs. 4.75 (4.0;5.38) mmol / l; p=0.000); lowdensity lipoprotein cholesterol (3.56 (3.12;4.63 ) mmol/l versus 3.09 (2.61;3.79) mmol/l; p=0.045) cystatin C (1.25 (1.08;1.70) mg / l versus 1.16 (0.99;1.42) mg/l; p=0.026) turned out to be significantly higher, and the calculated glomerular filtration rate (eGFR) significantly lower (57.0 ± 22 ml / min versus 65.0±23 ml/min; p=0.028)] compared with the 1^st group. A positive correlation was noted between the level of central BP (r=0.264; p=0.003), the augmentation index (r=0.224; p=0.011) and plasma cystatin C (r= 0.486; p=0.000) with the value of the indexed LV myocardium mass (LVMI) in the total sample surveyed. A negative correlation was recorded between the eGFR and LVMI (r=-0.425; p=0.000).

Conclusion: In the presence of hypertriglyceridemia in patients with left ventricular hypertrophy, cystatin C increases in blood plasma and GFR decreases with a tendency for augmentation index to increase.

Keywords: Hypertriglyceridemia; Left Ventricular Remodeling; Chronic Kidney Disease; Cystatin C

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