Study of Cardiovascular Involvement in Esrd Patients in a Tertiary Care Center

The increased prevalence of vascular disease in CKD patients derives from both traditional and CKD-related risk factors. Traditional risk factors include hypertensionhypervolemiadyslipidemiasympathetic over-activity and hyperhomocysteinemia. The CKD-related risk factors comprise anemiahyper-phosphatemiahyper-parathyroidism and generalized inflammation. Other abnormalities seen in CKD may augment myocardial ischemia including left ventricular hypertrophy and microvascular disease. Patients with chronic kidney disease are at significantly increased risk for both morbidity and mortality from cardiovascular disease. Diabetes (36%) was leading cause of end stage renal disease followed by hypertension (20.5%). Symptoms and signs related to cardiovascular system are evident in majority of patients. Mean serum creatinine level was 10.15+4.95mg/dl. Mean serum cholesterol level was 205.13+48.82; it was elevated in 58% of patients. Mean serum triglyceride level was 180.79+39.61; it was elevated in 82.5% of patients. Mean serum LDL level was 120.37+34.49; it was elevated in 88% of patients. Mean serum HDL level was 35.87+6; it was decreased in 77% of ESRD patients. X-ray finding showed cardiomegaly in 34.55 patients; pulmonary edema was present in 25.5% and pleural effusion was noted in 18% patients clinically evident cardiovascular abnormality in ESRD was observed in majority of patients. Left ventricle dysfunction was the commonest cardiovascular abnormality. Diastolic function was deranged in more number of patients compared to systolic function suggesting that diastolic dysfunction was first to appear in patients with ESRD. Major contributing factors for left ventricle hypertrophy and diastolic dysfunction were hypertension and anemia. Major contributing factor for systolic dysfunction was due to regional wall motion abnormality due to ischemic heart disease. Echocardiography was more sensitive in detecting LVH, diastolic dysfunction and minimal pericardial effusion prior to clinical detection.