Abstract
Cardiovascular diseases are the leading cause of death in hemodialysis patients. We aimed to evaluate non-traditional cardiovascular risk factors: homocysteine, high sensitive C-reactive protein, oxidized LDL antibodies, phosphate, and red cell distribution width in chronic kidney disease patients under maintenance hemodialysis along with traditional cardiovascular risk factors like age, hypertension, diabetes mellitus, among others. A total of 78 diagnosed chronic kidney disease patients under maintenance hemodialysis visiting a tertiary care center were included in the study, of which 59% were male. Hyperhomocysteinemia was present in 79.5% of the participants, with the median homocysteine level being 28.43 μmol/L. The median hsCRP level was 4.74 mg/L, and 59% and 24.4% of the total participants were at high and moderate cardiovascular risk respectively. The median oxidized LDL antibody level was 4235 U/mL, which is within the reference range. The median red cell distribution width was 14.05%, which is within the normal range. Left ventricular hypertrophy, a common cardiovascular disease in such patients, was found in 55.13% of the participants. Serum homocysteine level was significantly higher in patients with left ventricular hypertrophy, whereas serum C- reactive protein level was significantly lower in patients with left ventricular hypertrophy. The mean serum phosphate was 6.23 mg/dL (i.e. higher than normal) and hyperphosphatemia was seen among 76.9% of the patients. The mean age of the patients was 47.5 years, which is distinctly lower when compared to the hemodialysis patients in the Western population. The prevalence of hypertension, diabetes mellitus, and anemia were 95%, 18.25%, and 92.3%, respectively.
Highlights
Chronic kidney disease (CKD) is essentially a global epidemic, with a global prevalence of 9.1% and an estimated 697.5 million cases.[1]
Increased homocysteine is associated with high levels of triglycerides and cholesterol biosynthesis, as well as increased uptake of lowdensity lipoprotein (LDL) by macrophages contributing to cardiovascular disease (CVD) risk
The present study aimed to investigate some novel CVD risk factors along with some traditional factors among CKD patients undergoing maintenance hemodialysis and analyze how these risk factors are associated with CVD such as left ventricular hypertrophy (LVH)
Summary
Chronic kidney disease (CKD) is essentially a global epidemic, with a global prevalence of 9.1% and an estimated 697.5 million cases.[1] About 1.2 million deaths were reported in 2017, with an additional 1.4 million cardiovascular disease (CVD) mortality attributed to impaired kidney function. This makes it the 12th leading cause of death worldwide and the leading cause of death in CKD patients under hemodialysis.[2] This may be due to the higher prevalence of both traditional and non-traditional CVD risk factors among these patients when compared to the general population. Its role as a predictor of CVD morbidity and mortality in both the general population and ESRD has been questionable.[5,6]
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