PREVALENCE OF ECHOCARDIOGRAPHIC ABNORMALITIES AND ITS PATTERNS AMONGST PATIENTS WITH CKD

Abstract

CKD and cardiovascular diseases co-exist in many patients. The disorders of heart and renal system can deteriorate each other via direct or indirect ways in numerous complex mechanisms. Our study aimed to compare various echocardiographic parameters to predict the progression of CKD. We have conducted the study utilizing both the novel and traditional imaging techniques like speckle tracking for understanding the complex pathophysiological associations between the heart and kidneys. Methods: This prospective, cross-sectional, observational study was conducted on patients of chronic kidney disease (stage 2-5) to describe echocardiographic abnormalities (anatomical and functional) and its patterns amongst them. A person was considered having CKD if his illness was of more than 3 months’ duration and had abnormal USG findings and reduced creatinine clearance pointing to chronic kidney disease. GFR estimation was done using MDRD equation and classified according to the CKD classification. All patients underwent 2D echocardiography and examination was done under various standard echocardiographic views. Observations: A total of 90 patients in four groups of CKD (stages II, III, IV, V) were evaluated. Out of the 90 patients, 75 patients (83.3%) had LVH. The mean IVSd was 1.37 ± 0.14 cm. The mean LVMI was 134.38 + 24 .91 gm/m2. As the renal functions worsened, there was an increased prevalence of LVH (p=0.0008). There was a significant correlation worsening renal function and the prevalence of left ventricular systolic dysfunction (p<0.0001), left atrium enlargement (p<0.00001), and diastolic dysfunction (p<0.001). We found a strong statistically significant association between GLS and CKD patients with a (p< 0.00001). Conclusion: There was a significant correlation between LVH, dilated left atrium, abnormal GLS, TR-max velocity, diastolic dysfunction and related TDI parameters with worsening renal functions. Echocardiographic abnormalities are less severe in stage II-III CKD when compared with Stages IV and V CKD.