What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: End Stage Renal Disease (ESRD) (n=50). Intervention: 2-D Echocardiography. Primary outcome: Prevalence of diastolic dysfunction.

What does this research mean for the field?

In patients with end-stage renal disease on maintenance hemodialysis, 2-D echocardiography reveals a high prevalence of cardiac abnormalities, specifically diastolic dysfunction in 52% and left ventricular hypertrophy in 48% of patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 15, 2020Open Access

Evaluation of 2-D Echo Findings in Chronic Kidney Disease :A Case Study of 50 End Stage Renal Disease Patients

RPRuby PatelStanford Medicine DBDeepak BaldaniaGujarat Institute of Desert Ecology BBBabulal Bamboria

Resultado clave

In 50 patients with end-stage renal disease on maintenance hemodialysis, 2-D echocardiography revealed diastolic dysfunction in 52% and left ventricular hypertrophy in 48% of patients.

Diseño del estudio

Tipo

Cross-Sectional (n=50)

Multicéntrico

PICO estructurado

What is the prevalence of 2-D echocardiographic abnormalities in asymptomatic ESRD patients on maintenance hemodialysis?

Población

50 end-stage renal disease (ESRD) patients on maintenance hemodialysis for at least 3 months, with GFR <15ml/1.7m2. Excluded: obvious clinical evidence of coronary artery disease, valvular heart disease, pericardial effusion, rheumatic heart disease, congenital heart disease, and primary cardiomyopathy.

Intervención

2-D Echocardiography screening

Resultado

Prevalence of structural and functional echocardiographic abnormalities (left ventricular hypertrophy, systolic dysfunction, diastolic dysfunction, pericardial effusion, regional wall motion abnormality)surrogate

Echocardiographic screening in ESRD patients frequently reveals structural and functional abnormalities like left ventricular hypertrophy and diastolic dysfunction, which are particularly prevalent in those with concurrent anemia and hypertension.

Limitaciones

Small study population

Resumen

Chronic kidney disease (CKD) is a major public health problem worldwide with increase in incidence and prevalence. Diabetes and hypertension are the leading cause of CKD worldwide, whereas hypertension is a cause as well as effect of CKD. CKD is a risk factor for cardiovascular events and complications which increase as CKD progress to ESRD 3. Cardiovascular mortality is 10-20 times more common in ESRD patients on renal replacement therapy as compared to general population. One of the major structural cardiac abnormalities in CKD patients is left ventricular hypertrophy (LVH) and is associated with increased risk for cardiac ischemia, congestive heart failure, as well as a very strong independent predictor for cardiovascular mortality 4. Majority patients with CKD die due to cardiovascular events before reaching ESRD due to risk factors 5. Anemia and hypertension are most consistent with heart failure that causes 2/3rd death of all dialysis patients. ESRD patients do have myriads of structural and functional cardiac abnormalities which include LVH, depressed LV function, regional wall motion abnormality, pericardial effusion and valvular calcification.

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