Echocardiographic assessment of left ventricular hypertrophy in patients of chronic kidney disease

Authors

  • Bijaya K. Behera Department of General Medicine, M.K.C.G. Medical College and Hospital, Berhampur, Odisha, India
  • Sanjay M. Department of General Medicine, M.K.C.G. Medical College and Hospital, Berhampur, Odisha, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174672

Keywords:

Chronic kidney disease, Glomerular filtration rate, Left ventricular hypertrophy, Left ventricular mass index

Abstract

Background: Present study was conducted with an objective to study the prevalence of left ventricular hyper trophy (LVH) by echocardiography in patients with chronic kidney disease (CKD) and to find out correlation of left ventricular hypertrophy with severity of chronic kidney disease.

Methods: From November 2012 to September 2014, 100 chronic kidney disease patients who were admitted in hospital or attended on OPD basis for dialysis were taken for study. Detailed history, clinical evaluation, laboratory investigations and echocardiography was carried out. The diagnosis of CKD was made on basis of serum creatinine more than 1.5 mg/dl which remained constantly for more than 3 months. Patients with mild, moderate and severe CKD were having serum creatinine level 1.5-3mg/dl, 3-6mg/dl and > 6mg/dl respectively. Glomerular filtration rate (GFR) was calculated by modification of diet in renal disease (MDRD) equation. Cut-off for CKD was taken to be <60ml/min / 1.73m2 as per existing guidelines.

Results: Out of 100 patients studied, 67 were males and 33 were females. All patients were selected randomly. Majority of the patients were in the age group of 61 -70 years (41%). In the present study, it was found that left ventricular mass index (LVMI) which reflects LVH showed a progressive rise in severity of renal failure with 17 % of mild category of CKD having LVH as compared to 26% of moderate category and 57% of severe category of CKD.

Conclusions: Patients with CKD have LVH, which is more marked in patients with severe CKD. So, these patients should have a thorough cardiovascular evaluation even if there were no symptoms, and efforts should be made to prevent LVH, during the early course of renal insufficiency, such as strict control of hypertension, anaemia.

Metrics

Metrics Loading ...

References

Joanne M. Bargman, Karl Skorecki. Chronic Kidney Disease. In: Harrison’s principles of Internal Medicine. 19th ed.Mc Graw- Hill Education USA. 2015;2(19):1811.

Nahas E L and Winerals C G. Chronic renal failure 20.17.1 In: Oxford Textbook of Medicine. DJ Weatherall, et al. Oxford Medical Publications, 1996;3:3294-3306.

Foley RN, Parfrey PS, Sarnak MJ. Epidemiology of cardiovascular disease in chronic renal disease. JASN. 1998;9(12 Suppl):S16-23.

Mitsnefes MM, Kimball TR, Kartal J, Witt SA, Glascock BJ, Khoury PR, Daniels SR. Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study. J Pediatr. 2006;149(5):671-5.

Malikėnas A, Černiauskienė V, Jakutovič M, Jankauskienė A. Left ventricular geometry in children with chronic renal failure. Medicina. 2005;41:5-11.

Agarwal S, Dangri P, Kalra OP, Rajpal S. Echocardiographic assessment of cardiac dysfunction in patients of chronic renal failure. J Ind Acad Clinic Medic. 2003;4(4):297.

Dangri P, Agarwal S, Kalra OP, Rajpal S. Echocardiographic assessment of left ventricular hypertrophy in patients of chronic renal failure. Indian J Nephrol. 2003;13:92-7.

Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention. Americ J Kidney Dis. 1996;27(3):347-54.

Subramanyam CS, Gulati VK, Chatterji JC. Pattern of cardiovascular involvement in chronic uraemia. J Association of Physic Ind. 1980;28(9):263.

Chafekar DS, Rajani RM, Krishna BA, Almeida AF, Acharya VN. Left ventricular function in end stage renal disease--non-invasive assessment in patients on maintenance hemodialysis. J Association of Physic Ind. 1994;42(3):216-8.

Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray DC, Barre PE. Outcome and risk factors for left ventricular disorders in chronic uraemia. Nephrology Dialysis Transplantation. 1996;11(7):1277-85.

Downloads

Published

2017-10-27

How to Cite

Behera, B. K., & M., S. (2017). Echocardiographic assessment of left ventricular hypertrophy in patients of chronic kidney disease. International Journal of Research in Medical Sciences, 5(11), 4783–4788. https://doi.org/10.18203/2320-6012.ijrms20174672

Issue

Section

Original Research Articles