The goal of this observational study is to determine the prevalence of left ventricular hypertrophy among patients with chronic kidney disease at Sohag University Hospital and assess the effect of erythropoietin therapy on left ventricular mass and geometry in anemic CKD patients.

The main question it aims to answer is:

Does erythropoietin therapy mitigate or even reverse LVH and improve cardiac geometry ?

The prevalence of LVH in CKD patients has been reported to range from 40% to 75%, depending on disease stage, blood pressure control, and diagnostic methodology. LVH typically develops early and worsens with CKD progression, reflecting the close interplay between renal dysfunction and cardiac remodeling.

Anemia is a prominent non-hemodynamic contributor to LVH in CKD. Reduced erythropoietin (EPO) production by the damaged kidneys, together with iron deficiency and chronic inflammation, leads to decreased oxygen delivery, compensatory cardiac output elevation, and subsequent ventricular hypertrophy.

Given the strong association between CKD, anemia, and cardiovascular remodeling, investigating the prevalence of LVH and the effect of erythropoietin therapy on left ventricular mass among CKD patients can provide critical insights into optimizing cardiovascular risk management in this high-risk group.

this study will be conducted to :

1. To determine the prevalence of left ventricular hypertrophy among patients with chronic kidney disease at Sohag University Hospital.
2. To assess the effect of erythropoietin therapy on left ventricular mass and geometry in anemic CKD patients.

A total of 100 CKD patients will be included.

• Phase I : All CKD patients will undergo echocardiographic evaluation to determine the prevalence of LVH.
• Phase II : Among anemic CKD patients with LVH receiving erythropoietin therapy , will be followed for 6 months

Inclusion Criteria:

• Adults (≥18 years) diagnosed with CKD stages 3-5.
• Stable clinical condition for ≥3 months.
• Anemia (Hb <10 g/dL) for cohort phase.
• Willingness to participate and provide informed consent.

Exclusion Criteria:

• Valvular or ischemic heart disease.
• Uncontrolled hypertension (BP >180/110 mmHg).
• Acute coronary syndrome or decompensated heart failure in the past 3 months.
• Malignancy or active infection

study population is adults age (18-75)years, diagnosed with CKD stage 3-5 .