Abstract
Background: Chronic kidney disease (CKD) is a worldwide public health alarming problem. Although both heart and kidneys are separated by a quite distance within the body and they perform varied functions, there is a close physiological relationship between them. The diseases in the kidneys can trigger a disease in the heart and vice versa. High blood pressure is the most significant risk factor for the development and progression of chronic kidney disease (CKD). Lowering blood pressure is a goal to prevent CKD progress. Chronic abnormalities in cardiac function (e.g., chronic congestive heart failure) causing, chronic kidney disease and anemia appear to act together in a vicious circle in which each condition causes or exacerbates the other progressive chronic kidney disease. Objective: To assess the prevalence of chronic kidney disease in patients with cardiovascular disease at Shebin El-Kom Teaching Hospital and Menoufia University Hospital Cardiology Outpatient Clinic, Menoufia Governorate, Egypt. Methods: This is a cross-sectional study that was conducted in Shebin El-Kom Teaching Hospital Cardiology Outpatient Clinic, Menoufia University Cardiology Outpatient Clinic from April 2019 to July 2019. This study included 200 patients with cardiovascular disease or hypertension for more than 6 months. All patients were subjected to detailed history taking, clinical examination, laboratory investigation, echo and abdominal ultrasound. Results: This study included 200 patients with cardiovascular disease or hypertension for more than 6 months, which showed that: 63 (31.5%) were diagnosed as chronic kidney disease, 24 (38%) known to be CKD, 39 (62%) not known diagnosed in our study. Uncontrolled hypertension, congestive heart failure, diuretics and ACEI or ARBS with diuretics together are significant risk factors for renal impairment; uncontrolled hypertension and diuretics are the most predictors for renal impairment. Conclusion: Uncontrolled hypertension is the most preventable cause of renal impairment; RAAS not cause renal impairment but lead to decreased GFR in CKD patients. We should be careful with ACEI or ARBS with diuretics or diuretics only and control congestive heart disease to avoid kidney injury and chronic cardiorenal.
Highlights
Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD)
This study included 200 patients aged from 30 to 80 years (80 male and 120 female) the mean age of those patients are 59.5 ± 9.7, the mean glomerular filtration rate (GFR) are 87.03 ± 22.3, the mean BMI was 323.5, 31.5% known to be CKD and, 82.5% known to be hypertensive, 72.5% known to be IHD, 14% known to have congestive heart failure, 9% known to have valvular heart disease, 76.5% take ACEI/ARBs as treatment, 22% take diuretics as treatment, 41% take both ACEI/ARBs and diuretics as treatment as shown in Table 2 we collect patients from cardiology outpatient in Clinic Menoufia University and Shebin El Kom Teaching Hospital exclude diabetic patients as diabetes consider a main predictor for renal impairment worldwide
We made comparison between two groups regarding demographics as shown in Table 4 we found that congestive heart failure, uncontrolled hypertension, diuretics and diuretics and ACEI or ARBS together are significant risk factors in comparison between two groups as shown in Figure 1 and Table 4
Summary
Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). Chronic kidney disease (CKD) is the progressive and irreversible diminishing of kidney function, which leads to the accumulation of both toxins and fluid within the body [2] Both heart and kidneys are separated by a quite distance within the body and they perform varied functions, there is a close physiological relationship between them. Chronic kidney disease (CKD) is a worldwide public health alarming problem Results: This study included 200 patients with cardiovascular disease or hypertension for more than 6 months, which showed that: 63 (31.5%) were diagnosed as chronic kidney disease, 24 (38%) known to be CKD, 39 (62%) not known diagnosed in our study. Conclusion: Uncontrolled hypertension is the most preventable cause of renal impairment; RAAS not cause renal impairment but lead to de-
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