Abstract

ASSESSMENT OF CARDIAC DYSFUNCTION IN PATIENTS WITH END STAGE RENAL DISEASE IN A TERTIARY CARE HOSPITAL

Author(s): A. S. Veeramani Kartheek1, V. C. Srinivas Reddy2

BACKGROUND End stage renal disease (ESRD) is the irreversible deterioration of renal function which results from impairment of excretory, metabolic, endocrine functions leading to the development of the clinical syndrome of uraemia. Chronic Kidney disease (CKD) is recognised worldwide as a public health problem. In India, prevalence of CKD is high, and as per data available from various studies, approximate prevalence of CKD is around 800/million population.2-4 Diminished estimated glomerular filtration rate (eGFR) is a powerful, graded, independent predictor of cardiovascular morbidity and mortality5 and all-cause mortality. METHODS Patients with chronic kidney disease with End Stage Renal Disease admitted in King George Hospital, Visakhapatnam during the period from November 2018 to March 2019 were included in the study. This is a retrospective observational study. RESULTS A total of fifty CKD patients with ESRD were studied to determine the range of abnormalities of cardiac function. The predominant gender in the study group was male, constituting 68%. Hypertension was the most common aetiology of CKD with 21 (42%) patients, followed by hypertension & diabetes together (22%) and diabetes mellitus alone (20%). Other causes were NSAID abuse (6%), IgA Nephropathy (2%), Polycystic Kidney Disease (2%) & unknown aetiology (6%). Cardiovascular abnormalities were observed in large number of patients with ESRD (76%). LVH was the most common echocardiographic abnormality in CKD cases. Diastolic function was deranged more when compared to systolic function in patients with CKD. CONCLUSIONS High prevalence of left ventricular hypertrophy, diastolic dysfunction on echocardiography implies that these patients require detailed cardiovascular evaluation despite the absence of symptoms. Early detection of cardiac abnormalities by echocardiography before the development of overt cardiac symptoms might contribute to better prognosis in these patients.