Prevalence of Left Ventricular Hypertrophy in End Stage Renal Disease Patients on Maintenance Hemodialysis  : Ventricular Hypertrophy in End Stage Renal Disease

Afreen  Naz; Bhagwan  Das; Sughand  Memon; . Sanjay; Rafia  Memon; Kishor  Kumar

doi:10.54393/pjhs.v4i03.641

Authors

Afreen Naz Trauma Center, Hyderabad, Pakistan
Bhagwan Das Department of Nephrology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Sughand Memon Ziauddin University Hospital, Karachi, Pakistan
. Sanjay Department of Nephrology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Rafia Memon Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Kishor Kumar Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i03.641

Keywords:

Left Ventricular Hypertrophy, End Stage Renal Disease, Maintenance Hemodialysis

Abstract

Among the hemodialysis population, left ventricular hypertrophy (LVH) is becoming a major cause of cardiovascular death, mainly due to myocardial infarction, heart failure, and arrhythmias. Objective: To determine the frequency of left ventricular hypertrophy in ESRD patients on maintenance hemodialysis. Methods: The Descriptive Cross-sectional study was conducted at Department of Nephrology, Liaquat University of Medical and Health Sciences Jamshoro. All patients above 18 years of age and below 65 years of age of both gender having end stage renal disease on maintenance hemodialysis with 3 months or more of maintenance hemodialysis were consecutively enrolled. On dialysis free day patients meeting inclusion criteria was sent for Trans Thoracic Echocardiography. Measurements was taken as inter-ventricular septal thickness, left ventricular end-diastolic diameter and left ventricular posterior wall thickness through parasternal long axis or short axis just distal to the tip of mitral valve leaflet. Results: The mean age of the patients was 53.54 ± 11.63 years. There were 72 (61.5%) males and 45 (38.5%) females. The mean duration of hemodialysis was 5.61 ± 0.97 months. The mean duration of ESRD was 7.23 ± 0.78 months. Type 2 diabetes mellitus was found in 73 (62.4%) and hypertension in 71 (60.7%) patients. The frequency of left ventricular hypertrophy was found in 53 (45.3%) patients. Conclusions: The frequency of left ventricular hypertrophy was found to be 45.3% in ESRD patients on maintenance hemodialysis

References

Meijers B, Farré R, Dejongh S, Vicario M, Evenepoel P. Intestinal barrier function in chronic kidney disease. Toxins. 2018 Jul; 10(7): 298. doi: 10.3390/toxins10070298.

Anees M, Butt G, Gull S, Nazeer A, Hussain I, Ibrahim M. Factors Affecting Dermatological Manifestations in Patients with End Stage Renal Disease. Journal of the College of Physicians and Surgeons--pakistan: JCPSP. 2018 Feb; 28(2): 98-102. doi: 10.29271/jcpsp.2018.02.98.

Shafi S, Saleem M, Anjum R, Abdullah W, Shafi T. ECG abnormalities in patients with chronic kidney disease. Journal of Ayub Medical College Abbottabad. 2017 Jan; 29(1): 61-4. doi: 10.4103/1319-2442.229270.

Valentim B, Pereira A, Coelho P, Pereira T. Study of ventricular electrical systole in patients with end-stage kidney disease on hemodialysis. Arquivos Brasileiros de Cardiologia. 2013 Mar; 100: 261-8. doi: 10.5935/abc.20130063.

OmraniH, Golshani S, Sharii V, Almasi A, Sadeghi M. The relationship between hemodialysis and the echocardiographic findings in patients with chronic kidney disease. Medical Archives. 2016 Oct; 70(5): 328-31. doi: 10.5455/medarh.2016.70.328-331.

Gluba-Brzozka A, Franczyk B, Cialkowska-Rysz A, Olszewski R, Rysz J. Impact of vitamin d on the cardiovascular system in advanced chronic kidney disease (CKD) and dialysis patients. Nutrients. 2018 Jun; 10(6): 709. doi: 10.3390/nu10060709.

Pun PH. The interplay between CKD, sudden cardiac death, and ventricular arrhythmias. Advances in Chronic Kidney Disease. 2014 Nov; 21(6): 480-8. doi: 10.1053/j.ackd.2014.06.007.

BiqnottoLH, Kollas ME, Djouki RJ, Sassaki MM, Voss GO, Soto CL, et al. Electro cardiographic findings in chronic hemodialysis patients. Journal of Brazilian Nephrology. 2012 Jul; 34(3): 235-42. doi: 10.5935/0101-2800.20120004.

AmoakoYA, Laryea DO, Bedu-Addo G, Nkum BC, Plange-Rhule J. Left ventricular hypertrophy among chronic kidney disease patients in Ghana. Pan African Medical Journal. 2017 Sep; 28: 79. doi: 10.11604/pamj.2017.28.79.9183.

Kim SJ, Oh HJ, Yoo DE, Shin DH, Lee MJ, Kim HR. Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients. Plos One. 2012; 7(4): e35534. doi: 10.1371/journal.pone.0035534.

Chen SC, Su HM, Hung CL, Chang JM, Liu WC, Tsai JC. Echocardiographic parameters are independently associated with rate of renal function decline and progression to dialysis in patients with chronic kidney disease. Clinical Journal of American Society of Nephrology. 2011 Dec; 6(12): 2750-8. doi: 10.2215/CJN.04660511.

Wu Pr, Huang Jc, Chen Sc, Chen LI. Type 2 diabetes mellitus- related changes in left ventricular structure and function in patients with chronic kidney disease. Oncotarget. 2018 Feb; 9(18): 14661-8. doi: 10.18632/oncotarget.24482.

OqatoH, Kumasawa J, Fukuma S, Mizobuchi M, Kinuqasa E, Fukaqawa M. The cardiothoracic ratio and all- cause and cardiovascular disease mortality in patients undergoing maintenance hemodialysis: results of the MBD-5D study. Clinical and Experimental Nephrology. 2017 Oct; 21(5): 797-806. doi: 10.1007/s10157-017-1380-2.

Dervisoglu E, Kazdag G, Etiler N, Kalender B. Association of glomerular filtration rate and inflammation with left ventricular hypertrophy in chronic kidney disease patients. Hippokratia. 2012 Apr; 16(2): 137-42.

Mavrakanar TA, Khattak A, Singh K, Charytan DM. Echocardio graphic parameters and renal outcomes in patients with preserved renal function, and mild-moderate CKD. BMC Nephrology. 2018 Jul; 19(1): 176. doi: 10.1186/s12882-018-0975-5.

Rahn KH, Barenbrock M, Kosch M, SuelakB, Witta J. Vessel wall alterations in patients with renal failure. Hypertension Research. 2000 Jan; 23: 1:3-6. doi: 10.1291/hypres.23.3.

Murphy SW and Foley RN. Cardiac disease in dialysis patients, Divalent Ion abnormalities and Hyperparathyroidism In the Etiology of Cardiovascular Disease of Patients with Chronic Renal Failure. Semin Dialysis 1999; 12:97. doi: 10.1046/j.1525-139X.1999.00011.x.

Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention. American Journal of Kidney Diseases. 1996 Mar; 27(3): 347-54. doi: 10.1016/S0272-6386(96)90357-1.

Zoccali C, Benedetto FA, Mallamaci F, Tripepi G, Giacone G, Cataliotti A, et al. Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis. Journal of the American Society of Nephrology. 2001 Dec; 12(12): 2768-74. doi: 10.1681/ASN.V12122768.

Norris KC. Avoiding the risks of secondary hyperparathyroidism in chronic renal failure: A new approach, and a review. Dialysis & Transplantation. 2001; 30(6): 355-67.

Drazner MH, Rame JE, Marino EK, Gottdiener JS, Kitzman DW, Gardin JM, et al. Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: the Cardiovascular Health Study. Journal of the American College of Cardiology. 2004 Jun; 43(12): 2207-15. doi: 10.1016/j.jacc.2003.11.064.

Ulasi II, Arodiwe EB, Ijoma CK. Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. Ethnicity & Disease. 2006 Oct; 16(4): 859-64.

Tian JP, Wang T, Wang H, Cheng LT, Tian XK, Lindholm B, et al. The prevalence of left ventricular hypertrophy in Chinese hemodialysis patients is higher than that in peritoneal dialysis patients. Renal failure. 2008 Jan; 30(4): 391-400. doi: 10.1080/08860220801964178.

Kadiri ME, Nechba RB, Zajjari YR, Kabbaj D, Bouzerda M, Oualim Z. Association of adequate dialysis parameters with left ventricular hypertrophy in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2011 Nov; 22(6): 1133-41.

Kawamura M, Fijimoto S, Hisanaga S, Yamamoto Y, Eto T. Incidence, outcome, and risk factors of cerebrovascular events in patients undergoing maintenance hemodialysis. American Journal of Kidney Diseases. 1998 Jun; 31(6): 991-6. doi: 10.1053/ajkd.1998.v31.pm9631844.

Barre PE, Taylor R, Parfrey PS. Risk factors for the development of left ventricular hypertrophy in a prospectively followed cohort of dialysis patients. Journal of the American Society of Nephrology. 1994 Jan; 4(7): 1486-90. doi: 10.1681/ASN.V471486.

Ulasi II, Arodiwe EB, Ijoma CK. Left ventricular hypertrophy in African Black patients with chronic renal failure at first evaluation. Ethnicity & disease. 2006 Oct; 16(4): 859-64.

Sniderman AD, Silberberg JS, Prichard S. Anemia and left ventricular function in end stage renal disease, in Parfrey, Harnett JD (eds): Cardiac Dysfunction in chronic uremia. Boston MA Kluwer Academic. 1992: 161-71. doi: 10.1007/978-1-4615-3902-5_10.

Silverberg DS, Wexler D, Blum M, Keren G, Sheps D, Leibovitch E, et al. The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations. Journal of the American College of Cardiology. 2000 Jun; 35(7): 1737-44. doi: 10.1016/S0735-1097(00)00613-6.