Echocardiographic evaluation in patients with autosomal dominant polycystic kidney disease and end-stage renal disease

Cardiovascular abnormalities have been considered important extrarenal mani festations of autosomal dominant polycystic kidney disease (ADPKD). However , little is known about their prevalence in patients with ADPKD undergoing hemodialysis (HD). To investigate whether cardiac abnormalities are more pr evalent in these patients, clinical and echocardiographic manifestations of cardiovascular disease were evaluated in a group of 32 patients with ADPKD and a matched control group of 32 patients without diabetes treated by chr onic HD for more than 6 months. Predialysis systolic and diastolic blood pr essure (BP), prevalence of hypertension, and number of patients requiring a ntihypertensive medications were lower in the ADPKD group than controls. Th ere was no difference in the prevalence of cardiac events, including cardia c failure, ischemic heart disease, and arrhythmia. Systolic dysfunction, di astolic patterns, and left ventricular hypertrophy were similar in the two groups. In patients with ADPKD, simple regression analysis showed left vent ricular mass (LVM) index was correlated with hemoglobin level and predialyt ic systolic and diastolic BPs. In multiple regression analysis, predialysis systolic BP was the only independent variable linked to LVM index. The pre valence of aortic, mitral, and tricuspid valve disease did not differ betwe en groups. In conclusion, the occurrence of cardiovascular complications in patients with ADPKD is similar to that of HD patients with other primary r enal diseases, although hypertension is less prevalent. (C) 1999 by the Nat ional Kidney Foundation, Inc.