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ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 1  |  Page : 44-51

Study of echocardiographic changes among adult patients on maintenance hemodialysis


1 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
4 Department of Internal Medicine, Shebin Elkom Teaching Hospital, Menoufia, Egypt

Correspondence Address:
Fahim S Fahim
MBBCh, Shebin Elkom Teaching Hospital, 32511 Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.178949

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Objective The aim of this study was to identify the major echocardiographic abnormalities in end-stage renal disease (ESRD) patients on maintenance hemodialysis. Background Cardiovascular disease is the most important cause of mortality in patients with chronic kidney disease. Prevalence of cardiovascular death, especially in patients with ESRD, has been recognized as accounting for more than 50% of overall mortality in these patients. Patients with chronic kidney disease have a 3-30-fold risk for cardiovascular disease in comparison with the general population. Patients and methods A case-control study was conducted that included 40 patients with ESRD on maintenance hemodialysis and 10 apparently healthy volunteers as controls. All participants were thoroughly interrogated, examined clinically, and subjected to complete blood count, kidney function tests, evaluation of serum electrolytes, serum calcium, PO 4 level, lipid profile, fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, and serum parathyroid hormone, and to transthoracic echocardiography. Patients were classified into two groups according to the presence or absence of echocardiographic changes: group 1 (G1), with echocardiographic changes, and group 2 (G2) without echocardiographic changes. Results Echocardiographic changes were seen in 75% correct of the studied dialysis patients (30/40). The major echocardiographic changes were: concentric left ventricular hypertrophy in 80% of G1 patients, diastolic dysfunction in 53.3% of G1 patients, valvular calcifications in 40% of G1 patients, systolic dysfunction in 36.3% of G1 patients, and regional wall motion abnormalities in 33.3% of G1 patients. Left atrium was dilated in 26.6% of G1 patients, whereas pericardial effusion was seen in 16.7% of G1 patients and pulmonary hypertension in 16% of G1 patients. Conclusion Our study supports the high prevalence of echocardiographic changes in hemodialysis patients (75%) with predominance of left ventricular hypertrophy (80%) and diastolic dysfunction (53.3%).


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