Pattern of Cardio-Renal Syndrome Amongst End Stage Renal Disease Patients on Maintenance Hemodialysis
Introduction: Cardio-renal syndrome includes a broad spectrum of diseases in which heart and kidney are both involved and is classified into five types. From the early stages of chronic kidney disease to end stage renal disease, cardiovascular involvement is present, but left ventricle hypertrophy is highly prevalent in end stage renal disease and is associated with unfavorable prognosis. This study aimed to determine factors associated with left ventricular hypertrophy in patients with end stage renal disease of type two, four and five cardio-renal syndromes.
Methods: This prospective study was conducted in two hemodialysis centers in Aden, Yemen from June 2016 to January 2017. Data collected included socio-demographic, clinical and biochemical variables. Data analysis included descriptive statistics and multivariable logistic regression modelling.
Results: One hundred and five end stage renal disease patients were included in the study with a mean age of 47.1±12.96 years. Men constituted 67.6%. Cardio-renal syndrome type 4 (kidney disease), type 2 (hypertensive nephron-sclerosis) and type 5 (diabetic nephropathy) were observed in 39%, 30% and 17.2% of patients respectively. Echocardiographic left ventricle hypertrophy was observed in 40% with the aforementioned types of cardio-renal syndrome. Older age, male sex, arterial hypertension, prior history of chronic Kat use, low albumin and calcium, high creatinine in blood and anemia were the predominant features of patients with left ventricular hypertrophy and type four, two and five cardio-renal syndromes. However; on multivariate analysis, left ventricular hypertrophy was found to be only significantly related to systolic hypertension.
Conclusion: Left ventricular hypertrophy was prevalent in cardio-renal syndrome type 2, 4 and 5 of patients with end stage renal disease on maintenance hemodialysis and although it was found to be prevalent among patients with older age, males, chronic Kat user, hypertensive, those with low albumin and calcium, high creatinine and anemia yet it was only significantly related to systolic hypertension.
Keywords: Cardio-Renal Syndrome, Left Ventricle Hypertrophy, Hemodialysis, Echocardiography, Hypertension.