A STUDY OF CARDIAC DISEASES IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 62
Abstract
BACKGROUND The heart and the kidneys are tightly interlinked with each other. So, primary disorder of one of these organs often results in the secondary dysfunction of other. The patients with CKD most of the times die from cardiovascular diseases than progressing to End-Stage Renal Disease (ESRD). Cardiovascular diseases such as CAD (Coronary Artery Disease), HF (Heart Failure), arrhythmia and sudden cardiac death represent the leading causes of morbidity and mortality in the patients with CKD, increasing sharply as the patients approach ESRD. The aim of the is to study the– 1. Cardiac changes and complications in patients with chronic kidney disease; 2. Incidence of left ventricular dysfunction, concentric left ventricular hypertrophy and pericardial effusion in chronic kidney disease patients using echocardiography. MATERIALS AND METHODS Study was conducted among 54 patients with chronic kidney disease, admitted in Basaveshwara Teaching and General Hospital attached to Mahadevappa Rampure Medical College from January 2011 to August 2012. Settings and Design- A Cross-Sectional study was conducted. Cases were selected by random sampling method. RESULTS There were 40 males and 14 females. Pedal oedema, dyspnoea and chest pain were the common symptoms. 75 had symptoms for more than 6 months. Severe anaemia occurred in 40%. About 94.5% had serum creatinine more than 5 mg/dL. About 68.5% had stage 5 chronic kidney disease (creatinine clearance < 15 mL/min). Normal chest x-ray finding was present in 72.3%. ECG revealed LVH with pressure overload pattern in 18.5%. Low voltage complexes was seen in 3.7%. Echocardiography- pericardial effusion (46.3%) and concentric LVH (44.4%) were the common abnormalities. Dilated LV occurred in 25.9%, diastolic dysfunction in 27.8% and systolic dysfunction in 20.4%. CONCLUSION Pericardial effusion followed by concentric left ventricular hypertrophy were the commonest abnormalities in chronic kidney disease. Echocardiographically, it was better to detect the mild pericardial effusion and concentric left ventricular hypertrophy compared to x-ray and ECG. Hence, this necessitates screening of patients without cardiac symptoms for cardiac abnormalities immediately after the diagnosis of chronic kidney disease has been made.
Authors and Affiliations
Murugesh Pastapur, Mayur Takkar, Veerabhadra Swamy
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