Prognostic role of echocardiography in patients with chronic renal failure on hemodialysis

Abstract

BackgroundCardiovascular diseases (CVD) account for approximately 50% of all deaths in patients undergoing hemodialysis and account for approximately one third of their hospital admissions(1). Structural and functional alterations detected by echocardiography are important steps for the characterization of individuals with higher cardiovascular risk(2,3). Thus, we aimed to study the prognostic value of echocardiographic parameters in patients with CKD undergoing hemodialysis. Patients and methodsThis study include 61 patients (17 females) with age ranged from 21 to 72 years. All of them were on continuous regular hemodialysis 3 times per week for 3months at least. All patients underwent thorough history taking, full clinical examination, 12 lead ECG, and beside echocardiography. Then all patients underwent regular follow up for 6 months, the end points were the occurrence of fatal or non-fatal cardiovascular events. Our results6 patients developed cardiovascular morbidity; 4 unstable angina and 2 CHF beside 4 cardiovascular mortality one due to aortic dissection, one due to cerebral hemorrhage, one due to MI and one due to SCD.We had two groups, non-complicated group1 and complicated group2. By comparison between both groups we found that:-Left ventricular mass index (LVMI) ≥136 gm/m2 had 86% sensitivity and 85% specificity for the development of cardiovascular morbidity and mortality.-Age ≥49 years had 86% sensitivity and 64% specificity in predicting development of cardiovascular morbidity and mortality. ConclusionLVMI and age are the only predictors of cardiovascular morbidity and mortality in patients under hemodialysis with an odds ratio of 34.4 and 7.8 respectively