LEFT-VENTRICULAR HYPERTROPHY IN AUTOSOMAL-DOMINANT POLYCYSTIC KIDNEY-DISEASE

Cardiovascular complications are the most common cause of morbidity an d mortality in patients with autosomal dominant polycystic kidney dise ase (ADPKD). To understand this relationship, known cardiovascular ris k factors were examined in ADPKD. Left ventricular hypertrophy (LVH) i s a known, important risk factor for premature cardiovascular death in patients with essential hypertension. Hypertension is known to occur frequently and early in ADPKD patients. The frequency of LVH in ADPKD patients and its relation with hypertension and other risk factors, ho wever, is not known. In this study, echocardiographic tests were perfo rmed in 116 consecutive adult ADPKD patients and 77 healthy control su bjects. There was a significantly higher frequency of LVH in ADPKD men (46 versus 20%, P < 0.05) and women (37 versus 12%, P < 0.005) compar ed with control subjects. LVH in ADPKD patients was associated with hi gher systolic and diastolic arterial BP. There also was an association between LVH, diminished renal function, and increased renal volume. W hen comparing ADPKD patients with and without LVH, the former were old er, weighed more, had a higher prevalence of hypertension, and had a l ower hematocrit value and more renal impairment. LVH was also present in 23% of normotensive ADPKD patients and 16% of healthy control subje cts (P = NS), but did not correlate with BP. The role of BP as a contr ibuting factor to LVH in ADPKD patients may be due in part to earlier onset and inadequate treatment.