Echocardiographic Assessment for Early Detection of Cardiac Abnormalities in Patients with End-Stage Renal Disease Undergoing Renal Replacement Therapy
DOI:
https://doi.org/10.64960/srimedj.v40i6.267865Keywords:
end-stage renal disease, echocardiography, renal replacement therapyAbstract
Backgrounds and Objective: Cardiovascular disease is highly prevalent among patients with end-stage renal disease (ESRD) undergoing long-term renal replacement therapy (RRT). Early detection of abnormal cardiac structure may facilitate timely intervention and improve clinical outcomes.
Methods: This cross-sectional descriptive study analyzed echocardiographic data from 66 ESRD patients in a hemodialysis unit between March 15th, 2020, and December 31th, 2021. A total of 66 patients were included. Two-dimensional echocardiographic parameters were assessed to evaluate cardiac structure and function.
Results: The mean age of the patients was 63.5 years (57.3–72). Among the 66 patients, 36 (54.5%) were male, and 30 (45.5%) were female. Hypertension was present in 83.3% of patients, while 43.9% had diabetes. Left ventricular (LV) dilation was diagnosed in 7.6% of patients, LV systolic dysfunction in 16.7%, and LV hypertrophy (LVH) in 54.5%. Diastolic dysfunction was detected in 44 patients (66.7%) and valvular heart disease was observed in 20 patients (30.3%).
Conclusions: Echocardiography plays a crucial role in identifying cardiac abnormalities in patients with ESRD. The high prevalence of LVH and diastolic dysfunction underscores the need for routine cardiac evaluation in this population. Future research should focus on long-term follow-up to better understand the progression of cardiac dysfunction and its impact on patient outcomes.
References
Foley RN, Parfrey PS, Sarnak MJ. Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 1998;9(12 Suppl):S16-23.
Collins AJ, Foley RN, Gilbertson DT, Chen SC. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011). 2015;5(1):2–7. doi:10.1038/kisup.2015.2.
Cheung AK, Sarnak MJ, Yan G, Berkoben M, Heyka R, Kaufman A, et al. Cardiac diseases in maintenance hemodialysis patients: results of the HEMO Study. Kidney Int 2004;65(6):2380–9. doi:10.1111/j.1523-1755.2004.00657.x.
Harnett JD, Foley RN, Kent GM, Barre PE, Murray D, Parfrey PS. Congestive heart failure in dialysis patients: prevalence, incidence, prognosis and risk factors. Kidney Int 1995;47(3):884–90. doi:10.1038/ki.1995.132.
Foley RN, Parfrey PS, Kent GM, Harnett JD, Murray DC, Barre PE. Serial change in echocardiographic parameters and cardiac failure in end-stage renal disease. J Am Soc Nephrol 2000;11(5):912–6. doi:10.1681/ASN.V115912.
Yamada S, Ishii H, Takahashi H, Aoyama T, Morita Y, Kasuga H, et al. Prognostic value of reduced left ventricular ejection fraction at start of hemodialysis therapy on cardiovascular and all-cause mortality in end-stage renal disease patients. Clin J Am Soc Nephrol 2010;5(10):1793–8. doi: 10.2215/CJN.00050110.
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314. doi:10.1016/j.echo.2016.01.011.
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003.
Jameel FA, Junejo AM, Khan QUA, Date S, Faraz A, Rizvi SHM, et al. Echocardiographic Changes in Chronic Kidney Disease Patients on Maintenance Hemodialysis. Cureus 2020;12(7):e8969. doi:10.7759/cureus.8969.
Silberberg JS, Barre PE, Prichard SS, Sniderman AD. Impact of left ventricular hypertrophy on survival in end-stage renal disease. Kidney Int 1989;36(2):286–90. doi:10.1038/ki.1989.192.
Han SS, Cho GY, Park YS, Baek SH, Ahn SY, Kim S, et al. Predictive value of echocardiographic parameters for clinical events in patients starting hemodialysis. J Korean Med Sci 2015;30(1):44–53. doi:10.3346/jkms.2015.30.1.44.
Hee L, Nguyen T, Whatmough M, Descallar J, Chen J, Kapila S, et al. Left atrial volume and adverse cardiovascular outcomes in unselected patients with and without CKD. Clin J Am Soc Nephrol 2014;9(8):1369–76. doi:10.2215/CJN.06700613.
Hickson LJ, Negrotto SM, Onuigbo M, Scott CG, Rule AD, Norby SM, et al. Echocardiography Criteria for Structural Heart Disease in Patients With End-Stage Renal Disease Initiating Hemodialysis. J Am Coll Cardiol 2016;67(10):1173–82. doi:10.1016/j.jacc.2015.12.052.
Li Z, Liang X, Liu S, Ye Z, Chen Y, Wang W, et al. Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity. PLoS One 2014;9(12):e114392.
Malík J, Danzig V, Bednářová V, Hrušková Z. Echocardiography in patients with chronic kidney diseases. Cor et Vasa. 2018;60(3):e287–95. doi:10.1016/j.crvasa.2017.07.008.
Malik J, Lachmanova J, Kudlicka J, Rocinova K, Valerianova A, Bartkova M, et al. Left Atrial Dysfunction in End-Stage Renal Disease Patients Treated by Hemodialysis. Nephron 2016;133(3):169–74. doi:10.1159/000447500.
Palecek T, Skalicka L, Lachmanova J, Tesar V, Linhart A. Effect of preload reduction by hemodialysis on conventional and novel echocardiographic parameters of left ventricular structure and function. Echocardiography. 2008;25(2):162–8. doi:10.1111/j.1540-8175.2007.00580.x.
Trespalacios FC, Taylor AJ, Agodoa LY, Bakris GL, Abbott KC. Heart failure as a cause for hospitalization in chronic dialysis patients. Am J Kidney Dis 2003;41(6):1267–77. doi:10.1016/s0272-6386(03)00359-7.
Ke C, Ta I, Jl G, C Y, Rm H, Nj B. Combined angiotensin-converting enzyme inhibition and receptor blockade associate with increased risk of cardiovascular death in hemodialysis patients. Kidney Int 2011;80(9):978-85. doi:10.1038/ki.2011.228.
McIntyre CW, Burton JO, Selby NM, Leccisotti L, Korsheed S, Baker CSR, et al. Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol 2008;3(1):19–26. doi:10.2215/CJN.03170707.
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