الفهرس 
HYPERTENSIONOnly 14 pages are availabe for public view
 |  | from | 130 |  |  |
| | | from | 130 | | |
Abstract
Cardiovascular diseases are the leading cause of death for patients with chronic kidney disease. Cardiovascular risk of chronic kidney disease patients is significantly higher than in the general population , and the risk of a fatal Cardiovascular event is higher than the risk that their renal disease ,the increase of risk is alarming for patients with end-stage renal disease .
Hypertension in itself represents a powerful risk factor for Cardiovascular diseases in chronic kidney disease and is almost invariably present in patients with renal failure.
Hypertension also plays a major role in cardiac damage in chronic kidney disease via changes in left ventricular remodeling and left ventricular hypertrophy induction .
Left ventricular hypertrophy is the most powerful risk factor for coronary heart disease, ventricular arrhythmias, congestive heart failure and sudden death.
The progressive increase of LVH prevalence and left ventricular mass along with decreasing renal function.
In this study: we investigated the relationship between LV mass and mild-to moderate reduction of kidney function in a group of hypertensive patients, free of CV diseases.
The present study was done at Ainshams University hospital And at AlSahel Teaching Hospital, two hundered patients who are known to be hypertensive (defined according to the European Society of Hypertension (ESH)/European Society of Cardiology (ESC) Guidelines ( Mancia G et al .,2007), were included in this study ,during the period between (October 2010 - September 2013)
a group of participants with the following inclusion criteria:
- Age ≤ 65 years.
- Males and females
- Hypertension, patients should have clinic BP >140/90 mmHg as mean of three measurements in at least three visits at one-week intervals.
We excluded from the study those with:
7. Systolic readings greater than 260 mmHg or less than 70 mmHg , diastolic readings higher than 150 mmHg or less than 40 mmHg.
8. Heart failure.
9. History or clinical signs of coronary artery disease.
10. History of nephroparenchymal, renovascular, endocrine or malignant hypertension
11. History or clinical signs of cerebrovascular disease
12. Patients with a GFR of less than 30 mL/min per 1.73 m2
The participants were classified into three groups according to the levels of renal function:
Group (I): (normal kidney function), GFR of 90 mL/min per 1.73 m2 or more.
Group (II) : (mild reduction of GFR),GFR of 60–89 mL/min per 1.73 m2.
Group (III) : (moderate reduction of GFR), GFR 30–59 mL/min per 1.73 m2.
All patients included in the study were subjected to the following:
1- Full history and Full demographic data including sex, age, diabetes , presence of risk factors for Hypertension) obesity, dyslipideamia, smoking or family history..) ,duration of hypertension, duration of treatment
2- Clinical examination: vital signs including blood pressure, height, weight, and detailed physical examination to exclude heart and lung disease.
3- ECG: A 12 lead surface ECG was obtained to exclude resting changes denoting ischemia & to determine the presence or absence of LVH using CORNELL Voltage Criteria for LVH.
4- Echo-Doppler Study to evaluate Left Ventricular Mass.
5- Laboratory investigations : including Serum creatinine, serum electrolytes NA & K , hemoglobin level
Results of the current study showed that There was a significant statistical difference between the 3 groups Regarding LVMI. we found that LVMI showed a progressive rise with increase in severity of renal failure.
There was a significant statistical positive correlation between the levels of Systolic Blood Pressure & Diastolic Blood Pressure and LVMI among the study populations.
Also ,There was a significant statistical negative correlation between age & eGFR among all study populations.
So it was concluded that there is a high prevalence of LVH in patients with mild or moderate renal dysfunction.