Korean Journal of Nephrology 1998;17(5):754-761.

혈액투석 환자와 본태성 고혈압 환자의 심초음파 소견의 차이와 그 영향을 주는 요인들과의 상관관계 (Echocardiographic Differences between Hemodialysis and Essential Hypertension Patients and the Correlations with Factors Affecting the Differences)

노승현, 김은순, 정귀원, 고행일 (Seung Hyun Noh, Eun Soon Kim, Kui Won Jeong and Haeng Il Koh)

Abstract

To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass(192.56±63.6g vs 300.01±95.99g, P=0.000), r/th(radius/LV thickness, 4.41±0.97 vs 4.74±1.0, P=0.039), LV dimemsion and fractional shortening(4.68±0.6 vs 5.63±0.97, P=0.000, 30.0±19.7% vs 36.6±97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD(r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively(r=-0.344, P=0.002) and Kt/V(r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.