DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20200251

A tertiary care centre profile of heart diseases among diagnosed cases of chronic kidney disease

Vijay Bakhtar, Niyati Bakhtar, Neha Pandey, Nikhil Bakhtar

Abstract


Background: Chronic Kidney Disease (CKD) is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the predominant cause of morbidity and mortality in patients with CKD. There is limited data on cardiovascular diseases among CKD patients from developing countries including India. With the present study, the prevalence and patterns of cardiac diseases among patients with CKD were profiled.

Methods: This was a cross sectional study in which 217 patients with CKD were studied over a period of two years and six months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting ECG and echocardiography.

Results: One hundred eighteen (54.4%) patients had either eccentric or concentric LVH. Patients with LVH were more likely to be hypertensive (p<0.001) or anemic (p=0.034). Up to 9.2% of study subjects had valvular heart disease (rheumatic or degenerative) and 22% had pericarditis. Patients with pericarditis were more likely to have a serum urea concentration greater than 60mg/dl (p=0.327). Forty-one patients (18.9%) had left ventricular systolic failure (EF<50%). There was a statistically insignificant higher prevalence of systolic failure in patients with LVH (21% vs. 16%), (p=0.346). Thirty-eight participants (17.5%) had diastolic failure while 2% had cardiac rhythm abnormalities.

Conclusions: Cardiac abnormalities are common in a relatively young Indian population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.


Keywords


Cardiac disease, Chronic kidney disease, Clinical profile, Screening

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References


American Diabetes Association. Standards of medical care in diabetes-2013. Diabe Care. 2013 Jan 1;36(1):S11-66.

Danaei G, Lawes CM, Vander Hoorn S, Murray CJ, Ezzati M. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment. Lancet. 2006 Nov 11;368(9548):1651-9.

Amos AF, McCarty DJ, Zimmet P. The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabe Medi. 1997 Dec;14(S5):S7-85.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabe Care. 2004 May 1;27(5):1047-53.

Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, et al. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soci Nephrol. 2004 May 1;15(5):1307-15.

Segura J, Campo C, Gil P, Roldán C, Vigil L, Rodicio JL, et al. Development of chronic kidney disease and cardiovascular prognosis in essential hypertensive patients. J Am Soci Nephrol. 2004 Jun 1;15(6):1616-22.

Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention. Am J Kidney Dis. 1996 Mar 1;27(3):347-54.

Moran A, Katz R, Jenny NS, Astor B, Bluemke DA, Lima JA, et al. Left ventricular hypertrophy in mild and moderate reduction in kidney function determined using cardiac magnetic resonance imaging and cystatin C: the multi-ethnic study of atherosclerosis (MESA). Am J Kidney Dis. 2008 Nov 1;52(5):839-48.

Gjata M, Nelaj E, Collaku L, Gjergji Z, Tase M. Left ventricular hypertrophy in chronic kidney disease. Is pulse pressure an independent risk factor?. Med Archiv. 2011;65(1):30.

Ulasi II, Arodiwe EB, Ijoma CK. Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. Ethn Dis. 2006 Sep 1;16(4):859.

Horio T, Iwashima Y, Kamide K, Tokudome T, Yoshihara F, Nakamura S, et al. Chronic kidney disease as an independent risk factor for new-onset atrial fibrillation in hypertensive patients. J Hyperten. 2010 Aug 1;28(8):1738-44.

Wang AY, Ho SS, Wang M, Liu EK, Ho S, Li PK, et al. Cardiac valvular calcification as a marker of atherosclerosis and arterial calcification in end-stage renal disease. Archiv Int Med. 2005 Feb 14;165(3):327-32.

Floege J. When man turns to stone: extraosseous calcification in uremic patients. Kidney Int. 2004 Jun 1;65(6):2447-62.

Rostand SG, Rutsky EA. Pericarditis in end-stage renal disease. Cardiol Clin. 1990 Nov 1;8(4):701-8.

Datta S, Abraham G, Mathew M, Somasundaram H, Muralidharan TR. Correlation of anemia, secondary hyperparathyroidism with left ventricular hypertrophy in chronic kidney disease patients. JAPI. 2006 Sep;54:699-703.

Kumar S, Jeganathan J, Miryala L. Left ventricular hypertrophy in chronic kidney disease. Int J Med Pub Health. 2014;4(4).

Prasad R, HA KM, Surathkal M. Clinical and biochemical spectrum of chronic kidney disease in tertiary care center. J Evol Med Dent Sci. 2012;1:1214-22.

Arodiwe EB, Ulasi II, Ijoma CK, Ike SO. Left ventricular diastolic function in a predialysis patient population. West African J Med. 2010;29(4).

Ananthapanyasut W, Napan S, Rudolph EH, Harindhanavudhi T, Ayash H, Guglielmi KE, et al. Prevalence of atrial fibrillation and its predictors in nondialysis patients with chronic kidney disease. Clin J Am Soci Nephrol. 2010 Feb 1;5(2):173-81.