Left ventricular systolic function in a Nigerian pre-dialysis patient population with chronic kidney disease

BackgroundChronic kidney disease is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the primary cause of morbidity and mortality in patients with chronic kidney disease. There is limited data on cardiovascular diseases among chronic kidney disease patients in resource limited settings including Uganda. We determined the prevalence and patterns of cardiac diseases among patients with chronic kidney disease attending the nephrology outpatient clinic in Mulago National Referral Hospital in Uganda.MethodsThis was a cross sectional study in which two hundred seventeen patients with chronic kidney disease were recruited over a period of 9 months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting electrocardiography and transthoracic echocardiography performed for all study participants and findings entered into a data sheet.ResultsOne hundred eleven (51.2 %) of the 217 participants were male. Mean age was 42.8 years. One hundred eighteen (54.4 %) of patients had either eccentric or concentric left ventricular hypertrophy. Patients with left ventricular hypertrophy 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. Forty one patients (18.9 %) had left ventricular systolic failure (Ejection fraction < 50 %). There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346. Thirty eight participants (17.5 %) had diastolic failure while 2 % had cardiac rhythm abnormalities.ConclusionCardiac abnormalities are common in a predominantly young African population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

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Left Ventricular Structure, Geometry and Systolic Function among Hypertensive Black Patients with Reduced Kidney Function

Mpembe¹,

Lepira²,

Mbutiwi³

et al. 2015

WJCD

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Objective: To assess the LV mass, geometry and systolic function in hypertensive patients with reduced kidney function. Methods: According to ASE guidelines, we estimated LV ventricular mass, geometry and systolic function in 155 consecutive hypertensive patients [51% women, mean age 51 ± 12 years, median duration of hypertension 7 years] with reduced kidney function (eGFR < 60 ml/min/1.73 m 2 or dipstick proteinuria ≥ 1+). LVH was defined as LVMI >125 g/m 2 in men, >110 g/m 2 in non obese women or >51 g/m 2.7 for obese men or women. Where appropriate, we used Student t, Mann Whitney, one way ANOVA or Chi square tests. A P value of 0.05 or less was considered significant. Results: Seventy four patients in the series (48%) had reduced kidney function (eGFR 30 ± 15 ml/min/1.73 m 2 ). Compared to patients with relatively normal kidney function, non obese and obese patients with reduced kidney function had significantly greater LVM [271 (198 -348) vs 276 (175 -284) g/m 2 , p = 0.008] for non obese; LVM 72 (47 -88) vs 54 (44 -73) g/m 2.7 , p = 0.007 for obese] and lower EF (60 ± 14 vs 68 ± 13%, p < 0.001) was significantly lower. LVH of mainly concentric geometric pattern was present in 68 patients with reduced kidney function (92%). Conclusion: In the present case series, reduced kidney function was associated with increased LVM, concentric geometric pattern and impaired systolic function.

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Left ventricular systolic function in a Nigerian pre-dialysis patient population with chronic kidney disease

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Common echocardiography findings in pretransplant dialysis patients and their associations

Common echocardiography findings in pretransplant dialysis patients and their associations

Pattern and presentation of cardiac diseases among patients with chronic kidney disease attending a national referral hospital in Uganda: a cross sectional study

Left Ventricular Structure, Geometry and Systolic Function among Hypertensive Black Patients with Reduced Kidney Function

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