Abstract
Introduction: Echocardiography is a simple and established method of evaluating cardiac functions, assessing left ventricle geometry, and systolic and diastolic functions. Patients with chronic kidney disease have a tremendous burden of cardiovascular disease (CVD), and patients with end-stage renal disease (ESRD) are at a greater risk of CVD and deaths.Materials and Methods: In this study, 245 incident dialysis patients were included, and none of the patient was on erythropoietin. All the patients were aged >18 years. Patients with ESRD, already on maintenance dialysis, were not included in this study. Patient’s data such as demographic details, comorbidities, laboratory values, echocardiographic changes, management, and outcome were recorded.Results: Out of 245 patients, 165 (67.3%) were males and 80 (32.6%) females. The mean age of the patients was 49.7 years. Left ventricular hypertrophy (LVH) was observed in 188 (76.7%), mild left ventricular dysfunction (LVD) in 25.7%, moderate LVD in 23.67%, severe LVD in 8.5%, global hypokinesia in 33.8%, valvular heart disease in 26.5%, regional wall motion abnormality in 4.4%, and pericardial effusion in 1.6% patients. Echocardiographic changes, such as LVD, LVH, and global hypokinesia, were observed in greater number in hypertensive group com-pared to normotensive group (P < 0.05). On regression analysis adjusted for age and gender, we found that hypertension and anemia (<10 g/dL) were associated with LVH. Further, hypertension and anemia (Hb < 10 g/dL) were associated with LVD. Similarly, anemia (Hb < 10 g/dL) was associated with global hypokinesia and valvular heart disease. LVD was associated with death in our study.Conclusion: Echocardiography is a noninvasive diagnostic test which detects early changes in cardiac parameters. All ESRD patients with hypertension and anemia at the time of initiation of renal replacement therapy must undergo echocardiography screening.
Highlights
Echocardiography is a simple and established method of evaluating cardiac functions, assessing left ventricle geometry, and systolic and diastolic functions
One of the major structural cardiac abnormalities in patients with chronic kidney disease (CKD) is left ventricular hypertrophy (LVH), which is associated with increased risk for cardiac ischemia, congestive heart failure as well as a very strong independent predictor of cardiovascular mortality (1,6,7)
LVH was observed in 188 (76.7%), mild left ventricular dysfunction (LVD) in 25.7%, moderate LVD in 23.67%, severe LVD in 8.5%, global hypokinesia in 33.8%, valvular heart disease in 26.5%, regional wall motion abnormality (RWMA) in 4.4%, and pericardial effusion in 1.6% patients (Table 2). Echocardiographic changes, such as LVD, left ventricular hypertrophy (LVH), and global hypokinesia, were found in greater number in hypertensive group compared to normotensive group (P < 0.05) (Table 3)
Summary
Left ventricular hypertrophy (LVH) was observed in 188 (76.7%), mild left ventricular dysfunction (LVD) in 25.7%, moderate LVD in 23.67%, severe LVD in 8.5%, global hypokinesia in 33.8%, valvular heart disease in 26.5%, regional wall motion abnormality in 4.4%, and pericardial effusion in 1.6% patients Echocardiographic changes, such as LVD, LVH, and global hypokinesia, were observed in greater number in hypertensive group compared to normotensive group (P < 0.05). One of the major structural cardiac abnormalities in patients with CKD is left ventricular hypertrophy (LVH), which is associated with increased risk for cardiac ischemia, congestive heart failure as well as a very strong independent predictor of cardiovascular mortality (1,6,7). Left ventricular dysfunction (LVD) on start of hemodialysis is a stratifying risk of CVD and an all-cause mortality in ESRD (6,9) It is strongly associated with cardiac failure and as one of the independent predictors of cardiovascular death.
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