Limits...
Pattern and presentation of cardiac diseases among patients with chronic kidney disease attending a national referral hospital in Uganda: a cross sectional study.

Babua C, Kalyesubula R, Okello E, Kakande B, Sebatta E, Mungoma M, Mondo C - BMC Nephrol (2015)

Bottom Line: There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346.Cardiac abnormalities are common in a predominantly young African population with CKD.Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda. b2kriss@gmail.com.

ABSTRACT

Background: Chronic kidney disease is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the primary cause of morbidity and mortality in patients with chronic kidney disease. There is limited data on cardiovascular diseases among chronic kidney disease patients in resource limited settings including Uganda. We determined the prevalence and patterns of cardiac diseases among patients with chronic kidney disease attending the nephrology outpatient clinic in Mulago National Referral Hospital in Uganda.

Methods: This was a cross sectional study in which two hundred seventeen patients with chronic kidney disease were recruited over a period of 9 months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting electrocardiography and transthoracic echocardiography performed for all study participants and findings entered into a data sheet.

Results: One hundred eleven (51.2 %) of the 217 participants were male. Mean age was 42.8 years. One hundred eighteen (54.4 %) of patients had either eccentric or concentric left ventricular hypertrophy. Patients with left ventricular hypertrophy were more likely to be hypertensive (p < 0.001) or anemic (p = 0.034). Up to 9.2 % of study subjects had valvular heart disease (rheumatic or degenerative) and 22 % had pericarditis. Forty one patients (18.9 %) had left ventricular systolic failure (Ejection fraction < 50 %). There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346. Thirty eight participants (17.5 %) had diastolic failure while 2 % had cardiac rhythm abnormalities.

Conclusion: Cardiac abnormalities are common in a predominantly young African population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

No MeSH data available.


Related in: MedlinePlus

Patient/participant flow chart showing number of patients screened, number excluded (with reasons for exclusion) and number recruited into the study
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4522958&req=5

Fig1: Patient/participant flow chart showing number of patients screened, number excluded (with reasons for exclusion) and number recruited into the study

Mentions: A total of 258 patients were screened over a period of nine months. Forty one were excluded from the study for various reasons (Fig. 1). One hundred and six participants (106, 49 %) enrolled in the study were females. The mean age of study participants was 42.8 years (95 % CI = 40.6–44.9). About half of the patients had end stage renal disease (111, 51.2 %) but were not on renal replacement therapy (Fig. 2). A total of 184 patients (84.8 %) had proteinuria. One hundred sixty two patients (162, 74.65 %) had a non-reactive HIV antibody test within the past three months of recruitment, thirty two patients (32, 14.75 %) were HIV positive, while the remaining twenty three (23, 10.60 %) had no evidence for the HIV test in the past three months. The patient characteristics are summarized in Table 1. Twenty five patients (11.5 % of participants) had a positive history of cigarette smoking. Twenty two (10.1 %) were obese while 35 (16.2 %) had diabetes mellitus. Eighty nine participants (41 %) had high non-HDL cholesterol (≥130 mg/dL). One hundred fifty six participants (71.9 %) were anemic with hemoglobin concentration <11 g/dL (Fig 3).Fig. 1


Pattern and presentation of cardiac diseases among patients with chronic kidney disease attending a national referral hospital in Uganda: a cross sectional study.

Babua C, Kalyesubula R, Okello E, Kakande B, Sebatta E, Mungoma M, Mondo C - BMC Nephrol (2015)

Patient/participant flow chart showing number of patients screened, number excluded (with reasons for exclusion) and number recruited into the study
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4522958&req=5

Fig1: Patient/participant flow chart showing number of patients screened, number excluded (with reasons for exclusion) and number recruited into the study
Mentions: A total of 258 patients were screened over a period of nine months. Forty one were excluded from the study for various reasons (Fig. 1). One hundred and six participants (106, 49 %) enrolled in the study were females. The mean age of study participants was 42.8 years (95 % CI = 40.6–44.9). About half of the patients had end stage renal disease (111, 51.2 %) but were not on renal replacement therapy (Fig. 2). A total of 184 patients (84.8 %) had proteinuria. One hundred sixty two patients (162, 74.65 %) had a non-reactive HIV antibody test within the past three months of recruitment, thirty two patients (32, 14.75 %) were HIV positive, while the remaining twenty three (23, 10.60 %) had no evidence for the HIV test in the past three months. The patient characteristics are summarized in Table 1. Twenty five patients (11.5 % of participants) had a positive history of cigarette smoking. Twenty two (10.1 %) were obese while 35 (16.2 %) had diabetes mellitus. Eighty nine participants (41 %) had high non-HDL cholesterol (≥130 mg/dL). One hundred fifty six participants (71.9 %) were anemic with hemoglobin concentration <11 g/dL (Fig 3).Fig. 1

Bottom Line: There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346.Cardiac abnormalities are common in a predominantly young African population with CKD.Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda. b2kriss@gmail.com.

ABSTRACT

Background: Chronic kidney disease is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the primary cause of morbidity and mortality in patients with chronic kidney disease. There is limited data on cardiovascular diseases among chronic kidney disease patients in resource limited settings including Uganda. We determined the prevalence and patterns of cardiac diseases among patients with chronic kidney disease attending the nephrology outpatient clinic in Mulago National Referral Hospital in Uganda.

Methods: This was a cross sectional study in which two hundred seventeen patients with chronic kidney disease were recruited over a period of 9 months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting electrocardiography and transthoracic echocardiography performed for all study participants and findings entered into a data sheet.

Results: One hundred eleven (51.2 %) of the 217 participants were male. Mean age was 42.8 years. One hundred eighteen (54.4 %) of patients had either eccentric or concentric left ventricular hypertrophy. Patients with left ventricular hypertrophy were more likely to be hypertensive (p < 0.001) or anemic (p = 0.034). Up to 9.2 % of study subjects had valvular heart disease (rheumatic or degenerative) and 22 % had pericarditis. Forty one patients (18.9 %) had left ventricular systolic failure (Ejection fraction < 50 %). There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346. Thirty eight participants (17.5 %) had diastolic failure while 2 % had cardiac rhythm abnormalities.

Conclusion: Cardiac abnormalities are common in a predominantly young African population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

No MeSH data available.


Related in: MedlinePlus