Prevalence of Cardiovascular Dysfunctions in Patients Initiating Hemodialysis

Abstract

The number of patients with end stage renal disease (ESRD) is rapidly growing worldwide. Regular HD as a renal replacement therapy for those patients is associated with extremely high mortality rates, which are up to seven times greater than in the general population. Our study sample consisted of 100 clinically stable ESRD patients on regular HD who initiated their RRT in the 6 month prior to the study. Patients were collected from Ain Shams University Hospitals. In all patients, we recorded full history and clinical examination stressing on etiology of renal failure, predialysis nephrological and cardiological care and associated complication. We also recorded full lab results for every patient , echocardiograph was done for every patient to access cardiovascular dysfunctions in the study group .

Results of this study demonstrated that 15 subjects (15%) had ejection Fraction ≤ 45%, 36 subjects (36%) had left ventricular hypertrophy (LVH), 61 subjects (61%) had Left ventricular diastolic dysfunction (LV DD), 14 subjects (14%) had Segmental wall motion abnormality (SWMA), only 5 subjects (5%) had valvular calcification while 32 subjects (32%) were found to have left ventricular dilatation (LVD). Vascular access in majority of patients (92 subjects) was temporary venous catheter for HD (92%), while vascular access was arterio venous fistula (AVF) only in 8 subjects (all of them were receiving predialysis nephrological care) In our study population only 10 subjects (10%) received predialysis nephrological care. We found that patients who had predialysis nephrological care have serum creatinine lower than the patients who didn't receive nephrological care .

In our study we found higher prevalence of left ventricular