Echocardiographic Manifestations in Patients on Renal Replacement Therapy and Renal Transplant Recipients

Background: Chronic kidney disease (CKD) patients have 20–30 times greater risk of cardiovascular morbidity and mortality. Echocardiography is quintessential in cardiovascular evaluation and monitoring in CKD patients. This study was designed to determine the echocardiographic manifestations in patients on renal replacement therapy (RRT) and recipients of renal transplantation. Materials and Methods: An observational cross-sectional study was undertaken in a tertiary care hospital. All CKD patients on RRT or post renal transplant were included. Patients with known cardiac disease, malignancy were excluded. Demographic details, thorough history, physical examination and 2D echocardiography were performed for the patients. Results: Of the 51 patients, 60% were on dialysis and remaining were post renal transplant recipients. The mean age of study population was 44.16±13.66 years, with 64.7% males. 47% of patients were of age group of 41 years to 60 years. The most common etiology of CKD was hypertension in 16 (31.4%) followed by diabetes in 11 (21.6%). Only 8 patients (15.7%) had normal echocardiograms. LVH (80.4%) was most common abnormality, followed by diastolic dysfunction (74.5%), systolic dysfunction (13.7%), mitral regurgitation (13.7%) and pericardial effusion (5.8%). Around 95.2% had concentric hypertrophy. Diastolic dysfunction was observed in 90.2% and 80.9% of cases with LVH and hypertension respectively and was significantly associated with both (p=0.001, p=0.003 respectively). Conclusions: Left ventricular hypertrophy was the most common abnormality in CKD patients and renal transplant recipients. Diastolic function was affected in majority of patients. Early identification of cardiac abnormalities by echocardiography prior to manifestation of cardiac complications may result in better prognosis for this patient population.