Study on Echocardiographic Parameters of Left Ventricular Dysfunction Before and After Initiation of Maintenance Hemodialysis in End-stage Kidney Disease Patients

Background Chronic kidney disease (CKD) is a global health issue, resulting in approximately one million fatalities annually. Cardiovascular complications continue to be a significant contributor to mortality, and this was a study conducted to assess the changes and risk reduction of cardiovascular complications after initiating maintenance hemodialysis. Objective of the Study To study echocardiographic changes before and after initiation of dialysis in ESKD patients with a simple non-invasive bedside assessment of 2D Transthoracic Echocardiography (TTE). Methodology It was a cross-sectional observational study. All the patients included in the study either attended the out-patient department or were admitted at Sri Ramachandra Institute of Higher Education and research, over a period of 3 months. The study included patients aged >18 years who had given written consent and fulfilled the KDIGO (Kidney diseases improving global outcomes) criteria of CKD stage 5 requiring hemodialysis initiation. Results A total number of 57 patients were included in the study. The mean age was 46 ± 10 years. Among co-morbidities, 53 patients (93%) were hypertensive and 44 patients (77.2%) also had diabetes mellitus. The mean LVIDs (Left ventricular end-systolic diameter) was 32±3mm (pre-HD initiation) as compared to 31±3.3mm 3 months post-HD(hemodialysis) initiation. The mean EF (ejection fraction) pre-HD was 42% and 48% after 3 months of HD. Conclusion We advocate for a two-fold approach. Firstly, we recommend that all end-stage renal disease patients undergo an echocardiogram screening before commencing dialysis. Secondly, we propose that these patients should be re-evaluated after receiving adequate hemodialysis.