Title: To Study the Serial Echocardiographic Changes and their Clinical Correlation with Anaemia and Hypertension in end Stage Renal Disease (ESRD) Patients on Maintenance Haemodialysis
Authors: A K Nigam, P.K. Maheshwari, Vishwas K, Manish Bansal, Prabhat Agarwal, Abhishek Raj, Santhosh Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.179
Abstract
Background and Purpose: Left ventricular systolic and diastolic dysfunction is found in patients of end stage renal disease (ESRD) on maintenance haemodialysis. Main motive of this research is to identify the major determinant of left ventricular dysfunction and shed on some light to imply proper measures to prevent it.
Objectives: To study the serial Echocardiographic changes and their clinical correlation with anaemia and hypertension in end stage renal disease (ESRD) patients on maintenance haemodialysis.
Methods: The patients of end stage renal disease were taken into detailed history, examination and investigations at presentation (0th month) and at the end of 6th month. Echocardiography machine PHILIPS USA Mode – HD11XE was used with 24-2 transducer probe. Two dimensional echocardiography was performed. The LVEF was taken as measure of left ventricular systolic function. E/A ratio was taken as measure of left ventricular diastolic function. Echocardiographic findings were compared with anaemia and hypertension by serially monitoring the patients over a period of 6 months.
Results: Prevalence of ESRD was higher among males in anaemic, normotensive anaemic, anaemic and hypertensive groups. Prevalence of ESRD was higher among females in hypertensives, hypertensive patients without anaemia and in anaemic and hypertensive patients.
There was overall increasing trend in prevalence of systolic dysfunction as the duration of the disease progresses in patients of ESRD on maintenance haemodialysis. However, there was improvement in systolic dysfunction in anaemic patients, anaemic patients without hypertension and it remained static in hypertensive patients. There was deterioration of systolic dysfunction in the groups of, hypertensive patients without anaemia, hypertensive and anaemic patients. There was deterioration of diastolic function in the patients of ESRD on maintenance haemodialysis in all the groups. However, overall diastolic dysfunction prevalence increased to a greater extent in hypertensive patients without anaemia when compared to other two groups. But grade III diastolic dysfunction prevalence was increased to a greater extent in patients of hypertensive and anaemic patients.
Conclusion: The left ventricular systolic and diastolic dysfunction can occur in patients of ESRD on maintenance haemodialysis. Hypertension was the major determinant of systolic and diastolic dysfunction in patients of ESRD on maintenance haemodialysis.
Keyword: ESRD, Echocardiography, Left ventricular systolic function, Left ventricular diastolic function.
