Key result
The prevalence of left ventricular diastolic dysfunction increased significantly with deteriorating renal function, reaching 77.8% in CKD stage 5 compared to 34.8% in stage 1 (OR 6.6).
Cross-Sectional (n=250)
No
Odds Ratio: 6.6
Absolute Event Rate: 77.8% vs 34.8%
p-value: p=0.0001
Left ventricular systolic and diastolic dysfunction are highly prevalent in admitted CKD patients and worsen with advancing CKD stages, highlighting the potential value of routine echocardiographic screening.
LV dysfunction highly prevalent in CKD and rises with stage; leaves open whether routine screening improves outcomes in prospective studies.
Background: There is a significant worldwide burden of CKD; which is likely to increase further. Cardiovascular diseases constitute major cause of morbidity and mortality in CKD. LV dysfunction may be present despite the asymptomatic phase during the early stages of CKD. Thus, early detection of LV dysfunction and targeted interventions can improve prognosis in CKD.Methods: This cross-sectional study was conducted among 250 CKD admitted patients. Echocardiographic examination was done to determine the systolic and diastolic function of LV. For LV systolic function ejection fraction and % fractional shortening were calculated and for LV diastolic function E/A, E/E’, E deceleration time and IVRT were measured.Results: Among 250 study subjects, 112 (47.8%) had systolic dysfunction and 138 (55.2%) had diastolic dysfunction. The prevalence of systolic as well as diastolic dysfunction increased significantly (P<0.05) with deteriorating renal function (39.1% for CKD stage 1 and 67.8% for stage 5 for systolic dysfunction, 34.8% for CKD stage 1 and 77.8% for stage 5 for diastolic dysfunction).Conclusions: LV systolic and diastolic dysfunctions are significantly prevalent among CKD patients which increase with increasing severity of CKD. Hence, it is important to routinely screen these patients for LV dysfunction. The use of echocardiography can detect LV dysfunction at an early stage among the high-risk population of CKD to help plan appropriate strategies to slow the progression of cardiac dysfunction and improve prognosis.
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Rao et al. (2018) conducted a cross-sectional in Chronic kidney disease (CKD) (n=250). Chronic kidney disease severity (Stage 5) vs. CKD Stage 1 was evaluated on Prevalence of left ventricular diastolic dysfunction (OR 6.6, p=0.0001). The prevalence of left ventricular diastolic dysfunction increased significantly with deteriorating renal function, reaching 77.8% in CKD stage 5 compared to 34.8% in stage 1 (OR 6.6).
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