Frequency, Prognosis and Risk Factors of Congestive Heart Failure in Dialysis Patients Attending Public Hospitals in Pakistan

Abstract

Introduction: Congestive Heart Failure (CHF) in patients with dialysis is a concern increasing morbidity and mortality.Research was conducted to evaluate CHF in dialysis patients; it`s frequency and prognosis among patients attending public healthcare institutions in Pakistan. Methods: This was a multicenter cohort study whereby data of 117 patients for one year was evaluated retrospectively. Results: All patients had End-Stage Renal Disease (ESRD) and were on regular maintenance hemodialysis therapy. 7.7 % patients had Non-Insulin Dependent Diabetes Mellitus, 4.3% had Ischemic Heart Disease, 78.6% had Left Ventricular Hypertrophy and 80.34% had Cardiomyopathy. 38.5% were confirmed with CHF. 31.6% had systolic dysfunction, 6.8% had diastolic dysfunction and 3.4% had both systolic and diastolic dysfunction. Among patients with systolic dysfunction, 2.6% measured Left Ejection Ventricle Fraction (LEVF) of ≤ 20%, 13.7% measured 21-30% and 15.4% measured 3-40%. Additionally, 28.9% developed de novo CHF. Recurrence of CHF was observed in 57.7% and mortality rate was 24% in CHF group. Conclusion: Incidence of CHF was relatively high in these patients. Frequent recurrence of the disease, re-hospitalization and enhanced mortality is evident of adverse prognosis of CHF in ESRD patients. CVD must not be considered separately in ESRD patients. Appropriate management and correction of risk factors of co-morbid conditions can be helpful in improving the disease condition..