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.
