Abstract
Background: Chronic Renal Insufficiency is a major public health problem. Cardiovascular Disease is the leading cause of morbidity and mortality in patients at every stage of Chronic Kidney Disease. There is a 10-200 fold increased risk of cardiovascular disease in those with Chronic Kidney Disease compared to the age and sex matched with general population, depending on the stage of Chronic Kidney Disease. Objective: The objective of the study was to see correlation, if any, of cardiac status and stage of kidney disease. Materials and methods: The study was conducted at M. M. Institute of Medical Sciences and Research, Mullana, Ambala. Thirty patients of Chronic Kidney Disease were included in the study. Chronic Kidney Disease is defined as kidney damage lasting for more than 3 months characterised by structural or functional abnormalities of the kidney, with or without decreased Glomerular Filtration Rate (GFR), according to the K/DOQI Guidelines. Inclusion criteria were based on symptomatology and clinical history of features suggestive of Chronic Kidney Disease. Symptoms, Signs and history of the patients were used to filter out patients who did not fit in the criteria and selected patients on the basis of criteria were further evaluated and investigated. All patients were subjected to detailed history and clinical examination. Patients with age <20 years, with history of Diabetes Mellitus, Dyslipidemia, Intrinsic Diseases of Ventricles, Congenital Heart Disease and chronic smokers were excluded from the study. A standard 12 lead ECG was done in all cases. Echocardiography was done in ECHO lab of Cardiology unit in MMIMSR. Echocardiographic assessment was done by using Model vivid Colour Doppler Echocardiography machine of GE make. Apical four chamber view was employed to obtain the measurements of Left ventricular volume in diastole and systole, Ejection fraction; Left Ventricular Indices were assessed and then were used to calculate Left Ventricular Mass by using the cube formula proposed by Devereux. Patients included in the study were treated as per the standard treatment schedule. The data obtained was analysed with appropriate statistical analysis tools at the end of the study and conclusive evidence was derived. Results: In the present study the mean Left Ventricular Mass was 249.76 ± 69.35 gms with 73% study cases having Left Ventricular Mass more than the reference range, also Left Ventricular Mass showed a progressive rise with increase in S. Creatinine levels. In the present study, Left Ventricular dysfunction was seen in nearly half of the cases while approximately one-fourth cases (23%) also had Systolic Dysfunction. Pericardial Effusion was also observed in 10 % the study cases in the present study.Conclusion: Cardiac functions particularly Left Ventricular parameters. Left Ventricular free wall thickness and Left Ventricular Mass being common abnormality in CKD patients.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.207-215
Highlights
Chronic Renal Insufficiency is a major public health problem
Pericarditis can be accompanied by pericardial effusion that is seen on echocardiography and can rarely lead to tamponade, the pericardial effusion can be asymptomatic, and pericarditis can be seen without significant effusion
Due to presence of conditions like left Staging of chronic kidney disease ventricular hypertrophy, left ventricular dilation, Chronic Kidney Disease has been divided into five heart failure and valvular diseases, higher rates of stages based on guidelines of the National Kidney almost all arrhythmias are seen in Chronic Kidney Foundation [Kidney Dialysis Outcome Quality
Summary
Chronic Renal Insufficiency is a major public health problem. The number of patients with End Stage Renal Disease has steadily increased over the years. Ischemic vascular changes The presence of any stage of Chronic Kidney Disease is a major risk factor for ischemic cardiovascular disease, including occlusive coronary, cerebrovascular and peripheral vascular disease. A form of low pressure pulmonary edema can occur in advanced Chronic Kidney Disease, manifesting as shortness of breath and bat wing distribution of alveolar edema fluid on the chest x-ray This occurs due to increased permeability of alveolar capillary membranes due to uremic state. Due to presence of conditions like left Staging of chronic kidney disease ventricular hypertrophy, left ventricular dilation, Chronic Kidney Disease has been divided into five heart failure and valvular diseases, higher rates of stages based on guidelines of the National Kidney almost all arrhythmias are seen in Chronic Kidney Foundation [Kidney Dialysis Outcome Quality. Disease, including bradyarrythmias and heart Initiative, KDOQI] depending on the estimated block[12]
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