POS-544 CARDIOVASCULAR COMORBIDITY IN CKD 5D PATIENTS RURAL AND URBAN POPULATION OF THE REPUBLIC OF UZBEKISTAN

Abstract

Chronic kidney disease (CKD), defined by a low estimated glomerular filtration rate (GFR), is a common risk factor for cardiovascular disease (CVD). The risk increases with decreasing GFR and is highest (approximately 20 times the general population) in patients with end-stage renal disease (ESRD) requiring dialysis. Uzbekistan is a country with a population of 34 million and has an equal urban and rural population. In this regard, it is of interest to comparatively study the structure of cardiovascular diseases in patients with stage 5 CKD receiving hemodialysis of the rural and urban population of the Republic of Uzbekistan. A total of 165 patients with CKD 5D were examined. All patients, depending on their permanent place of residence, were divided into two groups: 104 patients(51 men and 53 women) of the urban population were included in the "URBAN" group, 61 patients from rural areas(39 men and 22 women) were included in the "RURAL" group. The average age of the urban population was 49.9 ± 1.62 years, the rural population was 45.5 ± 1.83 years. The main initial diseases were glomerulonephritis (46%), diabetes (26.7%) and urolithiasis (8.5%). All patients underwent programmed hemodialysis with identical devices and according to the same scheme: 12 hours a week. CVD comorbidity occurred in 55,8% (n=92) of all 165 examined patients. The most common CVDs in all groups were hypertension (51%, n=84), coronary heart disease, presented as angina (28%, n=47), heart failure (14%, n=23) and various types of arrhythmias (5%, n=8). 77% (n=127) of patients had anemia due ESRD. Diabetes occurred in 27% (n=44) of patients.In the group URBAN(n=104), 62.5% (n=65) had CVD. The main CVD was hypertension. It was found in 92% (n=60) of patients with CVD in this group. Less (65%, n=42) were patients with angina. Heart failure was detected in 31% (n=20) of patients. Arrhythmia was diagnosed in only 5% (n=5). A large number of combined CVD have been identified. 69% (n=45) of all patients with CVD had a combined CVDs in different combinations. The most common combination was hypertension + angina (n = 26). It accounted for almost 58% of all combined cases. Only 28% (n=17) of all cases with hypertension had "isolated" hypertension. The main combination with hypertension was hypertension + angina (43%, n=26), 11% (n=11) of patients had hypertension + angina + heart failure, a combination in the form of hypertension + angina + arrhythmia had 3% (n=3) patients.Relatively fewer (n = 27, 44%) CVD were found in the RURAL group. The most frequent CVD was also a hypertension. Patients with hypertension made up 89% (n = 24) of all patients with CVD in this group. The second place is occupied by angina, it was found in 18.5% (n=5) cases among patients with CVD. The combination of CVDs was presented much lower in this group. Combinations of hypertension + HF, angina + arrhythmia, hypertension + angina + HF and hypertension + HF + arrhythmia occurred 1 time, and the combination of hypertension + angina was found in only 2 patients.View Large Image Figure ViewerDownload Hi-res image Download (PPT) According to the results of our study, cardiovascular diseases in the urban population (62.5%) occur more often than in the rural population (44%). The most common CVD in urban and rural populations is hypertension. Combined CVD pathology occupies a leading place in the structure of CVD in patients with CKD 5D, both urban and rural.