Left ventricular hypertrophy in chronic kidney disease patients

Abstract

Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhtyhmias and sudden cardiac death represent main causes of morbidity and mortality in patients with chronic kidney disease (CKD). Pathogenesis includes close linkage between heart and kidneys and involves traditional and non-traditional risk factors. According to well - established classification of cardio - renal syndrome, cardiovascular involvement in chronic kidney disease is known as "Type 4 Cardio - Renal Syndrome" (chronic reno - cardiac). Uremic cardiopathy is mainly characterized by both left ventricular systolic and diastolic impairment, often associated to right heart dysfunction due to presence of vascular access for hemodialysis. Typical clinical picture is represented by left ventricular hypertrophy (LVH), which pathogenesis is multifactorial and closely linked to elevated blood pressure, vascular stiffness and atherosclerosis. Diagnosis is mainly provided by ultrasound (2D and 3D echocardiography) and cardiac magnetic resonance imaging (CMRI), although echocardiography is most widely employed because it's non - invasive and cheaper than CMRI. The following chapter makes an overview about epidemiology, pathophysiology, diagnosis and treatment key features of left ventricular hypertrophy CKD patients.