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NDT Advance Access originally published online on April 3, 2007
Nephrology Dialysis Transplantation 2007 22(6):1788; doi:10.1093/ndt/gfm157
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Email: heribert.schunkert{at}innere2.uni-luebeck.de

Sir,

We would like to thank Dr Bomback and Dr Klemmer for their interesting comments [1] on our recent paper [2]. Their mechanistic explanation for the association of low-grade albuminuria and LVH observed in a population-based sample, i.e. activation of the renin–angiotensin–aldosterone system with evolving renal damage, is quite plausible. Indeed, aldosterone has both myocardial and renal effects and plays important roles in the pathogenesis of both left ventricular hypertrophy and microalbuminuria. In support of the clinical and experimental data mentioned by Bomback and Klemmer, we recently demonstrated, in a population-based survey, that in particular serum aldosterone concentrations are associated with septal and posterior wall thickness in both women and men [3]. In addition, in women there was a strong association between serum aldosterone concentrations and echocardiographic indices of left ventricular mass, further underscoring the significance of aldosterone-related cardiac effects [3]. In the present independent community-based sample [2] however, serum markers of neurohormonal activity were not measured, and therefore not included in our statistical analyses.

Conflict of interest statement. None declared.

Wolfgang Lieb, Bjoern Mayer and Heribert Schunkert

Medizinische Klinik II,
Universitätsklinikum
Schleswig-Holstein,
Campus Lübeck, Germany

References

  1. Bomback AS, Klemmer PJ. Association of low-grade urinary albumin excretion with left ventricular hypertrophy in the general population: A reply. Nephrol Dial Transplant (2007).[Abstract/Free Full Text]
  2. Lieb W, Mayer B, Stritzke J, et al. Association of low-grade urinary albumin excretion with left ventricular hypertrophy in the general population: the MONICA/KORA Augsburg Echocardiographic Substudy. Nephrol Dial Transplant (2006) 21:2780–2787.[Abstract/Free Full Text]
  3. Schunkert H, Hense HW, Muscholl M, et al. Associations between circulating components of the renin-angiotensin-aldosterone system and left ventricular mass. Heart (1997) 77:24–31.[Abstract/Free Full Text]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/6/1788    most recent
gfm157v1
Right arrow Alert me when this article is cited
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Right arrow Email this article to a friend
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Right arrow Similar articles in ISI Web of Science
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Google Scholar
Right arrow Articles by Lieb, W.
Right arrow Articles by Schunkert, H.
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PubMed
Right arrow Articles by Lieb, W.
Right arrow Articles by Schunkert, H.
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