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Structural and Functional Changes in the Heart in Patients with Chronic Kidney Disease on Hemodialysis

Sandeep Sreedharan, Assistant Professor, Department of Nephrology, Amrita School of Medicine Amrita University, Kochi, Kerala, India. , Reshma Abraham* , Sandeep Sreedharan** , Zachariah Paul** , Anil Mathew*** , George Kurian**** , Rajesh R. Nair*****

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Urology, Nephrology and Andrology International 2(1):p 17-20, . | DOI:
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Abstract

Background: There is a higher risk of cardiovascular mortality in patients with chronic kidney disease (CKD) than in the general population. Structural and functional alterations in the heart are said to be the major causes of mortality in dialysis patients. Objectives: This study was designed to examine the structural and functional changes in the heart in patients undergoing hemodialysis. Methods: This was retrospective study done by chart review. Details of echocardiographic parameters of twenty patients at the initiation and after one year of hemodialysis treatment were collected and compared. Results: There were differences in the weight (64 ±12 Vs 57±12 kg, p= <0.001), left atrial size (35±1 Vs 35±1mg/dl, p=0.210), LVIDS (26±4 Vs 26±5mm, p=0.413), LVIDD (46±3 Vs 45±5mm, p+=0.082),IVS (12±3 Vs 13±3mm, p=<0.001),LVPW (11±1 Vs 12±1mm, p=0.016), left ventricular mass (202±64 Vs 205±59mg, p=0.001),left ventricular mass index (120±30 Vs 134±37gm/m2, p=0.023) and ejection fraction (61±24 Vs 58±59%, p=0.045). The frequency of diastolic dysfunction increased over a period of one year. There was also a significant reduction in the mean ejection fraction at the end of one year after dialysis. Conclusions: This study concludes that, in patients on hemodialysis, there are significant structural and functional changes in the heart, in the form of increase in left ventricular mass, increase in the prevalence of left ventricular hypertrophy and also reduction in systolic and diastolic functions.

Keywords: CKD; CVD; Left Ventricular Hypertrophy; India. 

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  • Sandeep Sreedharan, Assistant Professor, Department of Nephrology, Amrita School of Medicine Amrita University, Kochi, Kerala, India.
    ,
  • Reshma Abraham*
    ,
  • Sandeep Sreedharan**
    ,
  • Zachariah Paul**
    ,
  • Anil Mathew***
    ,
  • George Kurian****
    ,
  • Rajesh R. Nair*****
    ,
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