Cardiac Abnormalities in Patients with End-Stage Chronic Kidney Disease
Published: 2023-06-20
Page: 83-87
Issue: 2023 - Volume 6 [Issue 1]
Y. Hamine
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
S. Hamine *
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
Z. Benamara
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
M. Zamd
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
N. Mtioui
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
S. S. El-Khayat
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
G. Medkouri
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
M. Benghanem
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
R. Habbal
Service of Nephrology, Hemodialysis and Transplant Renal, University Hospital Ibn Roch, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Cardiac involvement is the leading cause of mortality and morbidity in patients undergoing chronic hemodialysis. Therefore, echocardiography is the preferred diagnostic test. Our study aims to describe the different cardiac lesions observed on transthoracic echocardiography and identify the associated risk factors. This was a single-center cross-sectional study that included adult patients who had been on hemodialysis for over a year and had undergone transthoracic echocardiography at the Casablanca University Hospital during 2021. Our descriptive and analytical study focused on analyzing demographic, clinical, biological, and echocardiographic data. We collected data from 65 hemodialysis patients, including 33 men (50.7%) and 32 women (49.3%), resulting in a male-to-female ratio of 1.02. The average age of the patients was 45.45 years ± 14.29 [18.82]. The average duration of hemodialysis treatment was 15.65 ± 9.445 years [1.34]. Among the patients, 47.7% were hypertensive (n=31), 58.5% were anemic (n=38), and 46.2% had hyperparathyroidism (n=30). The echocardiographic findings revealed that the most common abnormalities were left ventricular hypertrophy (LVH), observed in 67.7% of patients (n=44), and valvulopathies, observed in 66.2% (n=43) of patients. Valvular calcifications were noted in 12.3% of cases (n=8), pericarditis in 6.2% of cases (n=4), and left ventricular dilatation in 3.1% (n=2) of cases. Echocardiography remains the preferred examination due to its non-invasive nature, enabling accurate diagnosis of cardiac abnormalities and assessment of cardiovascular risk.
Keywords: Hemodialysis, echocardiography, chronic kidney disease
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References
London G. The cardiovascular system of chronic renal failure. Dialog. 2001; 117.
Di Lullo L, Floccari F, Polito P. Right ventricular diastolic function in dialysis patients might be affected by vascular access. Nephron Clin Pract. 2011; 118:c258–c262
Foley RN, Curtis BM, Randell EW, Parfrey PS. Left ventricular hypertrophy in new hemodialysis patients without symptomatic heart disease. Clin J Am Soc Nephrol. 2010;5:805–813.
Parikh SV, from Lemos JA. Biomarkers in Cardiovascular Disease: Integrating Pathophysiology into Clinical Practice. Am J Med Sci. 2006; 332:186–197
Foley RN, Parfrey PS, et al. Serial change in echocardiographic parameters and cardiac failure in end-stage renal disease. J Am Soc nephrol. 2000;11(5): 912–916.
London GM. Left ventricular alterations and end-stage renal disease. Nephrol Dial Transplant ; 2002.
Birchem JA, Fraley MA, Senkottaiyan N, Alpert MA. Influence of hypertension on cardiovascular outcomes in hemodialysis patients. Semi Dial. 2005; 18(5):391-5.
Ritz E, Wanner C. The challenge of sudden death in dialysis patients. Clin J Am Soc Nephrol. 2008;3:920–929.
Gross ML, Ritz E. Hypertrophy and fibrosis in uremia cardiomyopathy - beyond coronary artery disease. Semin dial. 2008;21:308–318.
Ritz E. Left ventricular hypertrophy in renal failure: beyond preload and afterload. Kidney Int. 2009;75:771–773.
Mominadam S, et al. Interdialytic blood pressure obtained by ambulatory measurement of blood pressure and left ventricular structure in hypertensive hemodialysis patients. Hemodiale Int. 2008;12:322–327.
Steigerwalt S, Zafar A, Mesiha N, Gardin J, Provenzano R. Role of aldosterone in left ventricular hypertrophy in African American patients with end-stage renal disease on hemodialysis. Am J Nephrol. 2007;27: 159–163.
Fielitz J, Hein S, Mitrovic V, Pregla R, Zurbrügg HR, Warnecke C, Schaper J, Fleck E, Regitz-Zagrosek V. Activation of the cardiac renin-angiotensin system and increased myocardial collagen expression in human aortic valve disease. Journal of the American College of Cardiology. 2001;37(5):1443-9.