ABSTRACT
Background: Chronic kidney disease is a potential threat of the 21st century, afflicting more than 50 million people all over the world. Cardiovascular diseases particularly increased left ventricular mass accounts for 40 – 50% deaths of kidney disease patients. Objective of the study: To find the factors which correlate with left ventricular hypertrophy in kidney disease patients. Materials and methods: A descriptive study was done on 75 chronic renal failure patients for a period of 6 months. Variables like proteinuria, creatinine clearance, anemia, blood pressure, serum albumin and other blood parameters were compared with left ventricular mass. Results: Of all the variables, the decline in estimated glomerular filtration rate and the increased amount of protein excretion affected the left ventricular mass index (p < 0.01). The mean GFR was 25 ml/min and the mean proteinuria > 3.5 g in females with left ventricular hypertrophy (>110 g/m2 ). With the cut-off for left ventricular hypertrophy in male > 134 g/m2 , the mean GFR was 20 ml/min and the mean proteinuria more than 7 g/L. Conclusion: Measures to decrease the amount of proteinuria and the rate of decline in glomerular filtration rate will prevent significant cardiovascular disease in chronic kidney disease patients.
ABSTRACT
Background: Electrolyte and acid-base disturbances are common in critically ill patients. Early appreciation and appropriate interventions to maintain this internal milieu are lifesaving and cost effective for the patients. Objective of the study: To analyze the effects of electrolyte and acid-base disturbances on hospital mortality in critically ill patients. Materials and methods: A retrospective case control study was done on 100 patients in the intensive care unit of our hospital for six months. Results: The incidences of electrolyte and acid-base disturbances were higher in non-survivors than survivors. The serum potassium value had both clinical (4.318 in the survivors vs. 4.815 in the nonsurvivors) and statistical significance (p=0.0298) between the survivor and non-survivor group. Arterial blood HCO3 (0.0304), CO2 (P=0.0396) and pH (P=0.015) at admission were statistically different between the two groups. The incidence rates of hyperkalemia (65%), respiratory acidosis (62.5%) and mixed metabolic acidosis and respiratory acidosis (65%) were higher in the non-survivor group. Conclusion: Electrolyte and acid-base disturbances hyperkalemia, respiratory acidosis and mixed respiratory with metabolic acidosis are highly associated with hospital mortality