ABSTRACT
Background: Chronic kidney disease is a major public health problem worldwide with continuously increasing incidence and prevalence. Diabetes and hypertension are the leading causes of chronic kidney disease worldwide, whereas hypertension is a cause as well as effect of chronic kidney disease. Objectives: To evaluate and analyze the echocardiographic changes in the end stage renal disease patients on maintenance haemodialysis by the help of 2-D echocardiography. Materials and methods: End stage renal disease (ESRD) patients who were on maintenance haemodialysis for at least 3 months, in MG hospital were included in the study. We performed 2- Dechocardiography in 50 ESRD patients during inter-dialytic period. Patients with clinical evidence of coronary artery disease, previous history of hypertension, valvular heart disease, congenital heart disease and pericardial effusion were excluded from this study. Results: out of 50 chronic kidney disease patients, echocardiography revealed LVH in 29 (58%) patients, LVDD in 25(50%) patients, pericardial effusion in 10 (20%) patients, pulmonary hypertension in 23(46%) patients, dilated left atrium in 14(28%) patients, dilated left ventricle in 4 (8%) patients and regional wall motion abnormalities in 3 (6%) patients. Hypertension was present in Saxena N, Dhamija JP, Saxena S. Role of 2-D echocardiography in detecting cardiovascular abnormalities in chronic kidney disease patients: Case series of 50 chronic kidney disease patients. IAIM, 2017; 4(1): 122-126. Page 123 46 (92%) out of 50 CKD patients out of which LVH was in 29 patients. Severe Anaemia was present in 10 (20%) patients. Conclusion: LV diastolic dysfunction and left ventricular hypertrophy were the most common and significant echocardiographic findings among 50 CKD patients. There was statistically significant correlation between anaemia and the presence of left ventricular hypertrophy and positive correlation between presence of hypertension and left ventricular hypertrophy.
ABSTRACT
Background: Chronic kidney disease (CKD) is a major public health problem worldwide with increase in incidence and prevalence. Diabetes and hypertension are the leading cause of CKD worldwide, whereas hypertension is a cause as well as effect of CKD. Objectives: To evaluate and analyze the echocardiographic changes in the end stage renal disease patients on maintenance hemodialysis. Materials and methods: End stage renal disease (ESRD) patients who were on maintenance Haemodialysis for at least 3 months, in MG hospital were included in the study. We performed 2D echocardiography in 35 ESRD patients during inter-dialytic period. Patients with clinical evidence of coronary artery disease, valvular heart disease, congenital heart disease and pericardial effusion were excluded from the study. Results: Out of 35 ESRD patients, echocardiography revealed LV dilatation and diastolic dysfunction in 18 patients (51.2%) , LV hypertrophy in 17 patients (48%), systolic dysfunction and pericardial effusion in 10 patients (28.57%) and 6 patients (17.14%) respectively. RWMA was present in 3 patients (8.5%) and no valvular calcification was seen in any patient. In a sub group of 21 patients with Hb <10g%, LVH was present in 15 patients (71.42%) vs 2 out of 14 patients (14.28%) in patients group with Hb >10 g%. Hypertensive patients were 27 of 35 ESRD patients, 13 out of 27 had Dhamija JP, Saxena N, Saxena S. Evaluation of 2-D echo findings in chronic kidney disease: Case study of 35 end stage renal disease patients. IAIM, 2016; 3(9): 61-65. Page 62 higher prevalence of LVH (51.85%). Systolic dysfunction and RWMA was absent in normotensive group. Conclusion: LV diastolic dysfunction and hypertrophy were most common echocardiographic findings. There was statistically significant correlation between anaemia and presence of LVH and positive correlation between presence of hypertension and LVH.
ABSTRACT
A middle aged female patient, a case of Primary Sjogren’s Syndrome with renal tubular acidosis as revealed by severe hypokalemia along with normal anion gap, metabolic acidosis and acidic urinary pH had brain stem lesion which presented as quadriplegia, dysphagia and dysarthria. Laboratory tests revealed that anti-nuclear antibodies (ANA) and anti Ro/SSA antibodies were positive. MRI showed hyper intense lesion in T2W images in middle pons, typical characteristic of central pontine myelenolysis. So, patient was diagnosed as Primary Sjogren’s Syndrome with renal tubular acidosis with central pontine myelinolysis. She recovered with correction of hypokalemia, intravenous methyl prednisolone and cyclophosphamide.