THE STUDY OF ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC CHANGES IN CHRONIC KIDNEY DISEASE PATIENTS

Abstract

BACKGROUND: In people with CKD, cardio-vascular disease (CVD) is the
primary risk factor for morbidity and mortality. This elevated CVD risk may begin in
the initial stages of CKD, well before renal failure develops. AIMS &
OBJECTIVE: Our study aim is to identify Echocardiography changes in patients
with chronic kidney disease. MATERIALS AND METHODS: After obtaining
institutional ethical committee clearance from the institute, study was carried out in
out-patient department of General Medicine in Madhubani Medical College,
Madhubani, Bihar were included in the study. The study was done for a period of 1
year from November 2022 to October 2023. Study population: A pre-designed study
pro-forma was filled in relevant investigations and clinical assessments were carried
out in all cases. A total of 112 subjects were included by random sampling method.
All patients had a 12 lead ECG as well as comprehensive Trans- thoracic
echocardiography (ECHO) and 2d Doppler evaluation by using GE Medical System's
Vivid S5 High Performance Echocardiography machine. The end diastolic volume
(EDV), end systolic volume (ESV), and ejection fraction (EF) were calculated using
Modified Simpson's approach. An EF of 50% was considered
abnormal. RESULTS: In this study, ECG abnormalities were found in 24 patients
(48%). LVH was seen in 10 patients (20%). 5 patients had a left axis deviation (10
percent). In 5 patients (10%) conduction abnormalities were observed. 6 patients
showed signs of ischemia (12 percent). One patient had an arrhythmia (2 percent).
Hypertension was present in all LVH patients. In 3 individuals, left axis deviation
(LAD) was associated to LVH (6 percent). Two individuals (4 percent) with serum
potassium levels >5.5mEq/L showed signs of hyperkalemia. One patient had atrial
fibrillation. Three patients (6 percent) had left bundle branch block, whereas two had
right bundle branch block (4 percent). CONCLUSION: From our study it can be
concluded that the most prevalent morphological abnormality was left ventricular
hypertrophy. Patients on hemodialysis were vulnerable to conduction abnormalities.
The most prevalent cardiovascular abnormality observed was left ventricular
dysfunction. Conduction disturbances were more easily spotted with ECG.
Myocardial ischemia was more detected with echocardiography. To diagnose LVD,
2d-ECHO was more reliable than any other diagnostic method.