Left Ventricular Structure during Antihypertensive Treatment in Patients with Chronic Kidney Disease

The aim of our study was to investigate the left ventricular (LV) echocardiographic parameters and estimate the antiremodeling efficacy of eprosartan and lercanidipine in patients with chronic kidney disease, depending on the presence or absence of diabetic nephropathy (DN). Materials and Methods: The study included 121 patients (mean age 52.4 +/- 5.7 years) with CKD stage 3 (KDOQI, 2002). Patients were distributed in two groups according to the etiology of CKD. Group 1 consisted of 67 patients with non-diabetic CKD. Group 2 consisted of 54 CKD patients with DN. All patients had arterial hypertension grade 1 or 2 (ESH/ESC, 2013). All patients underwent clinical examination, echocardiography; GFR was estimated by the Cockcroft-Gault formula. Stages of chronic kidney disease (CKD) were determined according to the KDOQI 2002 classification. Eprosartan and lercanidipine were prescribed to patients after one week of lavage from previous antihypertensive therapy. This 6-month follow-up study compared the effectiveness of two courses of treatment. Results: Left ventricular hypertrophy (LVH) was observed in all CKD patients regardless of the presence or absence of DN. Eprosartan and lercanidipine showed the high antihypertensive efficacy expressing a reliable decrease in absolute values of SBP and DBP. In CKD patients with DN, on the background of a comparable antihypertensive effect, eprosartan, in comparison with lercanidipine, showed a more pronounced effect on the LV echocardiographic parameters associated with LVH regression.