Relationship between level of plasma adrenomedullin and ventricular remodeling in patients with chronic kidney disease

Batu; ZHEN Huai-meng; ZHANG Hong-ying; SU Hua-ke

doi:10.3969/j.1674-4055.2013.05.18

Abstract：Objective To observe the changes of plasma adrenomedullin (ADM) and discuss the relationship between ADM and ventricular remodeling in the patients with chronic kidney disease (CKD). Methods The CKD patients (n=60) were chosen from the 253rd Hospital of Chinese PLA from Jan. 2009 to Jul. 2010, and divided into group A (with stage 5 CKD, n=32) and group B (with stage 3 CKD, n=28). At the same time 60 cases with normal renal function were chosen as group C (control group). The level of plasma ADM was detected by using radioimmunoassay. The cardiac function indexes, including LVDd, IVST, LVPWT, LVEF and E/A were determined by applying color Doppler ultrasonic diagnostic apparatus. LVMI was calculated. The correlation between ADM and cardiac function indexes were analyzed by using the methods of linear correlation and multiple regression. Results The level of ADM was the highest [(35.22±28.22) pg/mL] in group A, followed by group B [(10.60±4.41) pg/mL] and the lowest in group C [(8.71±2.55) pg/mL], and the pairwise comparison among three groups showed statistical difference (P<0.05). LVDd, IVST, LVPWT and LVMI decreased and LVEF and E/A increased in order in group A, group B and group C, and there was statistical difference between group A or group B and group C, but no statistical difference between group A and group B. ADM was positively correlated to LVDd, IVST, LVPWT and LVMI, and negatively correlated to LVEF and E/A. After excluding the factors of sex, age, blood pressure, blood fat and hemoglobin, ADM still was the independent influence factor of LVPWT, LVDd and E/A (P=0.014, P=0.035, P=0.05). Conclusion The level of ADM increases significantly in CKD patients, which is one of independent risk factors of ventricular remodeling.