Echocardiographic findings in patients on chronic Hemodialysis: A single center study

Abstract

Cardiovascular complications are frequent among chronic hemodialysis (HD) patients. Early detection of these complications is important to allow timely and appropriate treatment. Echocardiography is a simple way to detect abnormalities in cardiac structure and function. The aim of this study was to analyze the echocardiographic findings in chronic HD patients. We included patients undergoing HD for more than 6 months and older than 18 years. All patients were receiving thrice weekly HD session and had an artery-vein fistula as vascular access. We excluded patients with chronic pulmonary disease, valvulopathy, atrial fibrillation or flutter. Transthoracic echocardiography was performed for each patient after the HD session. Twenty eight patients were included: 20 men and 8 women. The mean age was 49 ± 13,6 years. The mean duration of HD was 60,2 ± 50,7 months. A total of 39% of patients had hypertension and 28% were diabetic. The mean serum calcium and serum phosphorus was 82,62 ± 7,74 mmol/l and 59,08 ± 19,34 mmol/l respectively. The mean intact parathyroid hormone (PTH) was 752,70 ± 692,62 pg/ml. The mean ejection fraction was 60,36 ± 7%. Twenty five percent of patients had left ventricular systolic dysfunction. The mean diameter of the inferior vena cava was 1,3 ± 0,4 cm. Two patients had pericardial effusion. The mean left ventricular mass index (LVMI) was 130.5 ± 47,3 g/m 2 . 63% of patients had left ventricular hypertrophy(LVH). PTH was an independent risk factor associated with the LVMI ( P = 0.025). A total of 46.4%of patients had valvular calcification (VC). Hypertension and the duration of HD were significantly associated with the presence of aortic VC. Hypocalcemia was significantly associated with the presence of mitral VC( P = 0.028). LVH and VC were the most common echocardiographic abnormalities. Nevertheless, we should be aware that conventional imaging protocols seem to be insufficient to identify the full cardiovascular risk of our patients.