Echocardiographic assessment of patients with end-stage renal disease undergoing maintenance hemodialysis

Abstract

Objectives: Chronic kidney disease is a global health problem. End-stage renal disease (ESRD) patients have a high frequency of cardiac functional and structural abnormalities associated with higher mortality. Echocardiography is a valuable tool to assess cardiac structural and functional changes, which helps in stratifying prognostic risk factors and measuring the effectiveness of therapeutic intervention. Materials and Methods: We conducted a prospective, cross-sectional, hospital-based study for 1 year from 2076/11/05 to 2077/11/05 B.S (February 17, 2020, to February 17, 2021, A.D. Total of 65 patients with the diagnosis of ESRD undergoing maintenance hemodialysis (MHD) at Chitwan Medical College Hospital meeting inclusion criteria were enrolled. Detailed history, examinations, echocardiographic, and laboratory findings were recorded, and their association was compared with different explanatory variables. Data were analyzed using Statistical Package for the Social Sciences version 25. Results: The most common echocardiography finding among the 65 patients was valvular heart disease (VHD) (78.50%). Among them, 86.2% were undergoing hemodialysis (HD) twice weekly. About 92.7% had hypertension and 52.3% had diabetes mellitus. All had anemia with a mean hemoglobin of 7.86 ± 1.30 g/dL. The most common echocardiography finding was VHD (78.50%). There were statistically significant associations between the age of patients with a prevalence of VHD and systolic dysfunction; the presence of global hypokinesia with body mass index; and the presence of left ventricular hypertrophy (LVH) with calcium levels. Furthermore, a statistically significant difference in the duration of HD was observed with LVH. Conclusion: Cardiovascular diseases are the major cause of morbidity and mortality among ESRD patients undergoing MHD. The study identifies various factors influencing echocardiographic parameters in ESRD patients and highlights VHD as the most prevalent echocardiographic finding. It also emphasizes the importance of echocardiography as a valuable tool for assessing cardiac changes in these patients, aiding in risk stratification and the evaluation of therapeutic interventions.