STUDY OF CARDIAC FUNCTION IN PATIENTS WITH CHRONIC RENAL FAILURE AND ITS RELATION TO PARATHYROID HORMONE; AN ECHO DOPPLER STUDY

Abstract

Uremia exerts adverse effects on the functional integrity of almost all organ systems; the most important of which is the cardiovascular system. Cardiovascular complications account the major cause of morbidity and mortality in patients with ESRD. Chronic hemodialysis is associated with a 10 years patient survival rate of only 45%, and cardiovascular accidents account for more than 50% of deaths.

Cardiovascular problems in CRF may be recognized as four main intermixing categories: hypertension, atherosclerosis and hyperlipidemia, pericarditis, and heart failure. Various factors that may adversely affect cardiac functions are present in uremic patients and those treated by dialysis; the most important of which are hypertension, accelerated atherogenesis, anemia, acetate intoxication, dialysis induced hypoxemia, acidosis and electrolyte disturbances, thiamine depletion by dialysis, uremic toxins and hyperparathyroidism. PTH, the plasma concentration of which is raised in CRF, is incriminated in the pathogenesis of LV dysfunction in patients with CRF. Although some clinical data denoted that PTH could adversely affect the heart, these clinical studies were controversial and deserve further study.