Evolution of Left Ventricular Hypertrophy After Stabilisation of Chronic Kidney Disease: Results of a Prospective Study

Abstract

Background: Left ventricular hypertrophy (LVH) is a common and serious cardiovascular complication in patients with chronic kidney disease (CKD), contributing significantly to morbidity and mortality. Whether LVH can regress after stabilisation of CKD remains a key clinical question.
Objective: To evaluate the regression of LVH after one year of optimised treatment aimed at stabilising renal function and controlling cardiovascular risk factors in patients with CKD stages 3 to 5.
Methods: A prospective study included 40 patients (30–75 years old) with CKD stages 3–5 and echocardiographic LVH. Patients received optimised management over 12 months, including tight blood pressure control (<130/80 mmHg), correction of anaemia, and management of phosphocalcium metabolism. Echocardiographic measurements of left ventricular mass index (LVMI) were compared at baseline and after 12 months.
Results: After 12 months, 70% of patients showed regression of LVH, with complete normalisation in 25% and partial reduction in 45%. Regression was associated with optimal blood pressure control (p<0.01), effective correction of anaemia (p<0.05), and treatment of phosphocalcium disorders (p<0.05). Conversely, persistent LVH (30%) was linked to advanced myocardial fibrosis, rapid CKD progression (GFR <15 ml/min), and poor treatment adherence. LVH regression was accompanied by improved diastolic function, reduced NT-proBNP levels, fewer heart failure symptoms, and a 40% decrease in hospitalisations for cardiac decompensation.