CARDIAC INVOLVEMENT IN CHRONIC KIDNEY DISEASE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 31
Abstract
BACKGROUND At every stage of CKD, cardiovascular disease is the leading cause of morbidity and mortality with 30 to 45% of patients advancing to cardiovascular complications. (3) The aim of the study was to evaluate the prevalence of systolic and diastolic dysfunction, correlate degree of cardiac dysfunction with severity of chronic kidney disease. METHODS Present study was a prospective study of all CKD patients admitted in the department of General Medicine, VIMSAR, Burla between Oct 2013-Nov 2017. They were classified into 2 groups. Group B patients with mild to moderate CKD (N= 80) with serum creatinine (1.6-6 mg/dL), Group C patients with advanced CKD (n= 80) with serum creatinine (>6.0 mg/dL). Group A (No=80) taken as healthy controls. RESULTS 160 cases of chronic kidney disease in the age group of 16-75 years were included in the present study. The male/female ratio was 3:1. In Group B, maximum patients were in age group 56-75 years and in Group C, the age group was 36-55 years. In severe CKD (Group C), the no. of cases of left ventricular hypertrophy (LVH) along with systolic dysfunction (7.5%) was higher than mild to moderate CKD (Group B) which was 2.5%. LVH along with diastolic dysfunction in severe CKD (Group C) was 66 (82.5%) which was higher than mild to moderate CKD (Group B) 44 (55%). LV diastolic dysfunction was more prevalent than systolic dysfunction. In diabetic CKD patients, LV dysfunction was predominantly diastolic irrespective of the degree of LV hypertrophy. Diabetes mellitus was the commonest cause of CKD. Anaemia, Hypertension and LVH was the predominant comorbidity and detected in most of the patients. CONCLUSIONS In the present study, it was observed that the systolic function was well preserved in majority cases of CKD, whereas diastolic dysfunction was more common in CKD patients. Hence, cardiac evaluation should be performed early and aggressive measures should be taken to prevent or delay further progression to reduce cardiovascular morbidity and mortality. Anaemia and Hypertension being major co-morbid conditions contributing to LVH should be detected and treated early.
Authors and Affiliations
Malati Murmu, Gouri Oram, Sunil Kumar Sharma, Sangya Das
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