Echocardiography Based Assessment of Cardiac Function in Patients With Reno cardiac Syndro

Abstract

Objectives: There is rising world-wide burden of chronic kidney disease (CKD) with high Cardio-vascular mortality. This research aims to study echocardiography based cardiac function with respect to CKD stages. Study Design and Setting: This cross-sectional study was conducted at RIHS Islamabad (Jan 2021–Jan 2022) after ethical approval. Methodology: Total 130 adult CKD cases were included by consecutive sampling. Acute kidney injury and diagnosed/treated cases of cardiac disease were excluded. BMI and GFR was calculated. CKD staging done by KDOQI-classification. Cardiac impairment categorized by ECG and Echocardiography. Data analyzed by SPSS V-22 with Chi-square test. Results: Amongst 130 CKD cases, there were 66(51%) males and 64(49%) females. Mean age was 60+13.27 years, mean BMI was 24+4.2. Diabetes mellitus was observed in 100(76.9%), hypertension in 122(93.8%). Mean creatinine was 4.83mg/dl and mean GFR was 17.84 mL/min/1.73m2 . Twenty-five(19.2%) patients were on hemodialysis. Mean cardiac EF was 49.18%. EF was normal in 39(30%), mildly reduced in 40(30.8%), moderately reduced in 29(22.3%) and severely reduced in 22(16.9%), diastolic dysfunction seen in 08(6.2%). Twenty-five(18.5%) cases had congestive cardiac failure; 14(56%) compensated and 11(44%) decompensated CCF. There was significant association between GFR and EF (p<0.0001). Conclusions: Decline in cardiac function is associated with advanced CKD stages. Cardiac evaluation suggested at initial presentation of CKD, hence diagnosing asymptomatic compensated heart failure. Study finds high burden of diabetes, hypertension, anemia and IHD in CKD cases. GFR should be used rather than isolated creatinine in CKD. High clinical suspicion and early intervention may lead to better outcome.