Effect of Hemodialysis on Cardiac Structures and Functions in Chronic Renal Disease Patients

Abstract

Objective: Although dialysis is a revolutionary treatment for chronic kidney disease, cardiac pathologies continue to be a major cause of morbidity and mortality. Early diagnosis of dialysis related cardiac changes prolongs survival. The aim of our study was to assess the cardiac differences between hemodialysis patients and patients not receiving dialysis with estimated glomerular filtration rate (eGFR) <30 ml/dk. Materials and Methods: A total of 50 hemodialysis patients and 50 patients not receiving dialysis with eGFR<30 ml/dk were included in this study. Baseline characteristics, echocardiographic findings, hematological and biochemical parameters were compared between groups. Results: Age and gender were similar between groups. Dialysis patients were 69.3±10.5 years of age and 50% were male, patients not receiving dialysis with eGFR<30 ml/dk were 72±10 years of age and 40 % were male. (p=0.150, p=0.211, respectively). Also, hypertension [36(72%) vs 33(66%), p=0.333], diabetes mellitus [23(46%) vs 22(44%), p=0.500] and coronary artery disease [26(52%) vs 23(46%), p=0.345] were similar between groups. Left ventricular hypertrophy [43(86%) vs 33(66%), p=0.035] and tricuspid regurgitation [43(86%) vs 32(64%), p=0.010] were more common in dialysis patients. Pulmonary artery systolic pressure (mmHg) was higher in dialysis patients [33(25-40) vs 25(20-35), p=0.018]. Also, hemoglobin (g/dl) [10.8±1.5 vs 11.6±1.7, p=0.020], hematocrit (%) [33.2±4.6 vs 35.6±5.9, p=0.032] levels were lower and anemia [45(90%) vs 37 (74%), p=0.033] was more frequent in hemodialysis patients. Conclusion: Left ventricular hypertrophy, tricuspid regurgitation were more common and pulmonary artery systolic pressure levels were higher in dialysis patients compared to the patients not receiving dialysis with eGFR<30 ml/dk. Also, hemoglobin levels were lower in dialysis patients. This study emphasizes the importance of regular echocardiographic assessment for early diagnosis and management cardiac patologies in dialysis patients.