Common echocardiography findings in pretransplant dialysis patients and their associations

SummaryBackground/PurposeAbnormality in cardiac structure and function is common in chronic kidney disease (CKD) patients. We aimed to evaluate the prevalence of different abnormal echocardiographic findings in CKD patients and find their associated factors.MethodsThis retrospective cross-sectional study was conducted in the Nephrology and Dialysis Department of the Shiraz University of Medical Sciences. A total number of 1354 kidney transplant candidates between the years 2000 and 2010 were included. Association between variables was assessed by Chi-square test and Student t test. We analyzed our data using multivariate logistic and linear regression when appropriate.ResultsLeft ventricular hypertrophy (LVH; 47.5%) was the most common finding in this study, followed by left atrial enlargement (43.7%), diastolic dysfunction (25.4%), left ventricular end diastolic dilation (23.1%), and systolic dysfunction (18.5%), in order of frequency. Older age was associated with abnormality in all echocardiographic indexes. Male gender was associated with LVH and systolic dysfunction. We found an association between a longer duration since CKD diagnosis and LVH. Left ventricular end diastolic dilation, left atrial enlargement, and diastolic dysfunction were associated with a longer duration of dialysis. Anemia was associated with all echocardiographic abnormalities except diastolic dysfunction. Hypoalbuminemia and hypocalcemia were associated with only left atrial enlargement and left ventricular end diastolic dilation, respectively. Patients on peritoneal dialysis had a lower prevalence of left atrial enlargement and left ventricular end diastolic dilation.ConclusionDifferent echocardiographic abnormalities, especially LVH, are prevalent among CKD patients. Traditional risk factors, such as age, diabetes mellitus, and hypertension, and uremia-related risk factors, such as anemia and hypoalbuminemia, are associated with an increase in the prevalence of these abnormalities.背景：心臟結構及功能異常在慢性腎病患者 (CKD) 間相當常見，本研究旨在調查 CKD 患者間心臟超音波異常表現的盛行狀況及其中的相關因子。方法：這是伊朗設拉子醫學大學腎臟醫學與透析部的一項回溯性橫斷研究，納入 2000 至 2010 年間共 1354 位移植候選者，並採用卡方檢定及 Student's t test 以檢定各變項間的關聯性。結果：最常見的發現依序有：左心室肥大 (LVH) (47.5%)、左心房擴大 (43.7%)、舒張功能障礙 (25.4%)、左心室舒張末擴張 (23.1%)、及收縮功能障礙 (18.5%)。所有心臟超音波指標的異常均與年老有關，其中 LVH 及收縮功能障礙與男性性別有關。我們亦發現 LVH 與 CKD 診斷後的較長時間有關；左心室舒張末擴張、左心房擴大、及舒張功能障礙則與較長的透析時間有關。除了舒張功能障礙之外，貧血與所有的心臟超音波異常均有關。低白蛋白血症及低鈣血症，則分別僅與左心房擴大及左心室舒張末擴張有關。在正接受腹膜透析的病人間，左心房擴大及左心室舒張末擴張的盛行率均較低。結論：心臟超音波指標異常特別是 LVH 在 CKD 患者間相當常見，它們的出現與傳統的危險因子有關，例如年齡、糖尿病、及高血壓；及尿毒症的相關危險因子如貧血及低白蛋白血症。