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Abstract
BACKGROUND: Chronic kidney disease (CKD) is associated with increased cardiovascular risk. LVH is highly prevalent in CKD even in early stages, as compared to general non-selected population. This is mainly due to the multifactorial pathogenesis of left ventricular hypertrophy (LVH) in renal patients where both haemodynamic and non-haemodynamic stimuli synergically act inducing either an increase in left ventricular mass or an LV dilation. The presence of LVH in patients with CKD is associated with worsening cardiovascular outcomes.
OBJETIVES: To find the factors which correlate with left ventricular hypertrophy in chronic kidney disease patients.
MATERIALS AND METHODS: This study was done in the Department of Medicine of GMC & Hamidia hospital Bhopal. It was a hospital based prospective observational study in which 50 diagnosed CKD patients (stage 3 and 4) were studied. All the patients fulfilling the inclusion criteria were subjected to detailed clinical history, systemic examination, routine investigation, SUA measurement and echocardiography for determination of LVH. The results thus obtained from clinical/laboratory examinations were analysed with the ECHO findings to determine the correlation with progression in CKD. the categorical data was compared by using chi-square test. P value of < 0.05 is considered as significant.
RESULTS : The study had an mean age of 54 ± 13.49 years. Mean Ejection fraction of the patients was 54.13%. The mean baseline Systolic Blood pressure recorded was 150.92+24.82mmHg. with a range from 140 to 165 mmhg and Diastolic blood pressures recorded was 103.92 + 19.97mmHg. There were 27% of the patients who had left ventricular hypertrophy at baseline. Around 6 patients had RWMA and 16 patients had dilated cardiomyopathy. ECG revealed that, around 27% of the sample had LVH. At baseline, the patients LVH was determined to be 111.09±29.41. Majority (58.0%) of the sample have reduced ejection fraction
CONCLUSION: The results of this study conclude that more clinical trials are needed to assess guidelines for treating CKD related hypertrophic cardiomyopathy. Study also showed a higher percentage of hypertension patients were found in patients with a high LVH and uric acid, which was accompanied by a high LVH. Patients with hypertension, raised serum creatinine, high LVH, and high uric acid exhibited a statistically significant higher incidence of decline in renal function.