Study of etiology, mode of dialysis and cardiovascular morbidity among dialysis dependent chronic kidney disease patients in a tertiary care hospital

Bhushan C Shetty; Anoop Shetty

Volume : VII, Issue : VIII, August - 2018

Study of etiology, mode of dialysis and cardiovascular morbidity among dialysis dependent chronic kidney disease patients in a tertiary care hospital

Bhushan C Shetty, Anoop Shetty

Abstract :

Study of etiology,mode of dialysis and cardiovascular morbidity among dialysis dependent chronic kidney disease patients in a tertiary care hospital.

Introduction :Chronic kidney disease leads to many comorbidities that affects patients at all stages of the disease. Complications are due to disease itself as well as the mode of renal replacement therapy. Cardiovascular morbidity and mortality is highest in the dialysis population. Recently there has been found an association between RRT and development of pulmonary hypertension. There is a paucity of data on the incidence and prevalence of pulmonary hypertension in chronic kidney disease in Indian patients.

Objectives :To study the etiology , mode of dialysis and cardiovascular morbidity among dialysis dependent chronic kidney disease patients.

Materials and methods: A cross-sectional study ,where a random of 50 dialysis dependent CKD patients , who met the inclusion criteria were evaluated. The parameters like, etiology for CKD, hemoglobin levels, mode and duration of dialysis, 2D Echocardiogram for the presence of cardiovascular abnormality among dialysis dependent patients was studied.

Results :Of the 50 dialysis dependent CKD patients, 47 were on hemodialysis and 3 were on peritoneal dialysis. The etiology for CKD among subjects in my study was diabetes mellitus plus hypertension(50%), hypertension alone(44%), chronic glomerulonephritis(4%), chronic pyelonephritis(2%). All the patients had low hemoglobin levels with mean being 9gm%. The mean duration of dialysis was 19.32 months. Among the 50 patients, 6(12%) had concentric LVH, 40 (80%) had pulmonary hypertension and 4(8%) had normal 2Decho.Patients had significant linear relation between duration of dialysis and severity of PH. Of the 3 patients on PD, 1 had pulmonary hypertension and 2 had LVH.

Conclusion:The mechanisms underlying development of cardiovascular complications in CKD patients especially PH are more complex. This unrecognized complication of maintenance hemodialysis therapy is not uncommon, and perhaps most importantly is associated with reduced survival, therefore best approach to the disease is looking for it. It is important to evaluate for the impact of arteriovenous fistula on the pulmonary artery pressure(PAP) in pre-ESRD period.