Variety of Cardiac Events in Hospitalized Chronic Kidney Disease Patients.

Asfia Jabbar,Kiran Nasir,Aasim Ahmad,Murtaza Dhrolia,Ruqaya Qureshi

doi:10.7759/cureus.18801

Abstract

ObjectiveThis study assessed the variety and frequency of various cardiovascular events in different stages of chronic kidney disease (CKD) patients who were hospitalized due to different causes.MethodsThis prospective cross-sectional observational analysis was conducted at the Department of Nephrology in The Kidney Centre Post Graduate Training Institute Karachi on all adult CKD (of all stages with or without dialysis) patients, who developed cardiovascular events during their hospital admission either in ward or ICU due to any cause between August 2020 and February 2021. Total of 765 patients got admitted in the given time period and among them, 290 patients developed various cardiovascular events. Baseline data, co-morbidities, clinical features, drug history and management were determined.ResultsThere were a total of 290 patients in our study in which 154 (53.1%) were male and 136(46.9%) were female. Mean age was 57 ± 15.5. Our majority of patients were end-stage renal disease and on maintenance hemodialysis (n=119, 41%) while the most prevalent co-morbid condition was hypertension (n=227, 78.3%) followed by diabetes mellitus (n=204, 70.4%). The most frequent cardiovascular events in CKD patients was the atrial fibrillation 101(34.8%) while 37(12.8%) patients suffered ST-elevation myocardial infarction and supraventricular tachycardia. Patients who had high potassium levels (>5.2) most frequently suffered from atrial fibrillation (n=16, 28.1%) as compared to other cardiovascular events.ConclusionPatients with CKD are at increased risk of having several cardiovascular events. Numerous risk factors involved in the pathogenesis. Among the diverse causes, fluctuations in serum levels of various electrolytes are important causes as certain electrolytes disbalance can trigger various life-threatening cardiac arrhythmias.

Highlights

Chronic kidney disease (CKD) is a worldwide public health problem; an estimated 200 million people have CKD
In the United States, African Americans have a four-fold additional risk of CKD compared to nonHispanic white people and globally, people in the low-to-middle income countries like Asia and SubSaharan Africa have the maximum cases of CKD [1]
In stage 1 there is kidney damage with normal or increased GFR (>90 mL/min/1.73 m2), in stage 2 there is a mild reduction in GFR (60-89 mL/min/1.73 m2), in stage 3a there is a moderate reduction in GFR (45-59 mL/min/1.73 m2), in stage 3b moderate reduction in GFR (30-44 mL/min/1.73 m2), in stage 4 there is a severe reduction in GFR (15-29 mL/min/1.73 m2) and in stage 5 GFR is less than 10ml/min/1.73m2 in which patients needs renal replacement therapy either in the form of dialysis or renal transplantation

Summary

Introduction

Chronic kidney disease (CKD) is a worldwide public health problem; an estimated 200 million people have CKD. In stage 1 there is kidney damage with normal or increased GFR (>90 mL/min/1.73 m2), in stage 2 there is a mild reduction in GFR (60-89 mL/min/1.73 m2), in stage 3a there is a moderate reduction in GFR (45-59 mL/min/1.73 m2), in stage 3b moderate reduction in GFR (30-44 mL/min/1.73 m2), in stage 4 there is a severe reduction in GFR (15-29 mL/min/1.73 m2) and in stage 5 GFR is less than 10ml/min/1.73m2 in which patients needs renal replacement therapy either in the form of dialysis or renal transplantation. It is familiar that various CVE rises as renal function decline [2] and when the patient reaches end-stage renal disease (ESRD), the prevalence of CVE further rises. Ohtake et al have reported that when patient started on dialysis approximately half of the patients with CKD have significant coronary artery stenosis regardless of patient having symptoms of

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Conclusion