Cardiac disease burden amongst patients on chronic hemodialysis at Moi Teaching and Referral Hospital, Eldoret Kenya

Abstract

Background: Globally, cardiovascular disease (CVD) is the leading cause of mortality in patients with end stage renal disease (ESRD) on dialysis. The exact burden and type of cardiac disease in this patient population has not been characterized in Kenya. Objective:To determine the prevalence and type of cardiac disease in ESRD patients undergoing hemodialysis in MTRH. Methods: This was a cross sectional study conducted at MTRH renal unit, which enrolled adult patients with ESRD on dialysis between January and June 2016.The socio demographics, medical and drug history data were collected using a structured questionnaire; while anthropometric and blood pressure data were measured and recorded in a data collection form. All participants were subjected to a transthoracic Echocardiogram (ECHO) and a 12 lead resting Electrocardiogram for assessment of Ischemic heart disease, arrhythmias, left ventricular hypertrophy, systolic dysfunction and pathological valve disease. The prevalence estimates were reported with the corresponding 95% confidence intervals. Results: Among the 72 participants included in the final analysis, the median age was 41(29.8,60) years and 51.3% were male. Majority (93%) were on two sessions of dialysis per week, with 97.2% being known hypertensive among whom the majority (81.8%) had poorly controlled blood pressure. Overall; 72.2% (60.4,82.1) of the participants had one type of cardiac lesion as follows; left ventricular hypertrophy-58% (46.1,69.9); systolic dysfunction-25% (15.5,36.6); valvular heart disease-15.3% (7.9,25.7); benign rhythm anomalies-9.7% (4,19) and ischemic heart disease-6.9% (2.2,15.5). Conclusion: There is a high burden of cardiac disease in patients with ESRD on hemodialysis at MTRH with the predominant lesions being left ventricular hypertrophy and systolic dysfunction. Recommendation: Patients with ESRD on hemodialysis should be routinely screened for the presence of cardiac disease.