Cardiac status in CKD patients on maintenance hemodialysis to detect cardiovascular disease: importance of M mode Echocardiography
Dr. Preety Motiyani, Dr. RS Jagat, Dr. RR Barde, Dr. TN Dubey, Dr. RS Meena
Background: CVD mortality rates are much greater in dialysis patients despite stratification for sex, race, or age group. Younger dialysis patients have an approximately 500-foldincreased CVD mortality rate compared with their counterparts in the general population, and rates remain approximately five times higher, even among the oldest patients.Aims and Objectives: To assess cardiac status in CKD patients on maintenance hemodialysis to detect coronary artery disease including myocardial infarction, congestive heart failure (CHF), valvular deformities and pericardial disease by M mode Echocardiography Materials and Methods: One hundred and fifty patients were studied at Department of Medicine Gandhi Medical College and associated Hamidia Hospital Bhopal from September 2016 to June 2019. After detailed clinical evaluation in patients with feature suggestive of CKD, all the patients had undergone urine (PH, Specific gravity, Protein, Sugar, Microscopy), blood (HB%, FBS/PPBS, Urea, Creatinine, Electrolyte, Calcium, Phosphorous) and ultrasound abdomen. M mode electrocardiography (12 lead ECG) was done on patient with chronic kidney disease. Results: Majority of the patients belong to age group of 60-70 years. Majority of the patients were male [90 (60.7%)]. ECHO findings revealed that diastolic dysfunction were present in 90.67% patients, LVH in 86.67, RWMA in 57.33 and pericardial effusion in46.67% patients. Most common valve abnormality was MR/TR in 36.2% patients, among most common chamber abnormality DCMP (36.6%) was most common. Hypertensive patients had significantly more LVH (74.66%) as compared to non hypertensive (12%) (P=0.012). Patients with hypertension had higher percentage of diastolic dysfunction (88.67%), RWMA (55.33%) and pericardial Effusion (46%). Patients with anemia had higher percentage of diastolic dysfunction (85.33%), LVH (82%), RWMA (54%) and pericardial Effusion (44.67%). Non diabetes patients had higher percentage of diastolic dysfunction (29.33%) and LVH (60%) as compared to diabetes whereas RWMA (40.67%) and Pericardial Effusion (32.67%) were higher among diabetes. Conclusion: Cardiovascular abnormalities in chronic kidney disease were observed in maximum no of patients and left ventricular dysfunction was the commonest cardiovascular abnormality.
Dr. Preety Motiyani, Dr. RS Jagat, Dr. RR Barde, Dr. TN Dubey, Dr. RS Meena. Cardiac status in CKD patients on maintenance hemodialysis to detect cardiovascular disease: importance of M mode Echocardiography. International Journal of Medicine Research, Volume 4, Issue 2, 2019, Pages 130-134