Prevalence of Arrhythmia in End Stage Renal D...

Prevalence of Arrhythmia in End Stage Renal Disease Patients

Author Name : Dr. Samridhi Ladhani, Dr Y N Verma

ABSTRACT Chronic kidney disease is defined as the presence of kidney damage or an estimated glomerular filtration rate less than 60 ml/min/1.73 mt2, persisting for 3 months or more, irrespective of the cause. It is a state of progressive loss of kidney function ultimately resulting in the need for renal replacement therapy . A cardiovascular mortality that is 15 to 30 times greater than the age-adjusted cardiovascular mortality in the general population affects roughly 50% of people with ESRD.Ninety-four patients on haemodialysis program wereenrolled in the study. Routine laboratory results were noted.Arrhythmia, periods of silent ischemia, and heart-rate variabilityanalyses were obtained from 24-hour Holter monitor recordings. Corrected QT (QTc) dispersion was calculated from 12-lead surfaceEKG. Echocardiographic and tissue Doppler examinations were performed on interdialytic days as well. Ventriculararrhythmia was classified according to Lown classification; classes 3 and above were accepted as complex ventriculararrhythmia.The mean age was 52.5±13.2years; 44 (46.8%) were women. Ventricular premature contractionswere detected in 80 (85.1%) patients, of whom 35 (37.2%)were classified as complex ventricular arrhythmia (CVA). Coronaryartery disease, hypertension, and QTc dispersion appearedas independent factors predictive of CVA development. Atrial premature contractions (APC) were detected in 53 patients(56.4%) and supraventricular arrhythmia in 15 (16%) patients;all were identified as atrial fibrillation. Duration of dialysis therapywas found as an independent predictor of APC.LVH, LAE were very common ECG and ECHO abnormalities in ESRD patients. Cardiac disorders are highly prevalent in patients with progressive ESRD. All ESRD patients must be evaluated for cardiac co-morbidities, since it might help to establish adequate treatment that may potentially improve patient’s prognosis