To study pattern and prevalence of cardiovascular Morbidity intradialytic hypotension patients

Abstract

Background & Method: This Study was conducted at Department of General Medicine, NSCB Medical College and Hospital, Jabalpur (MP) on patients coming for dialysis with chronic renal failure from all over mahakaushal area of central India with an aim to study pattern and prevalence of cardiovascular Morbidity intradialytic hypertensive patients. Result: Mean Post-dialytic systolic Blood Pressure for hypertensive group was 145.88 ± 22.06 mmHg which was significantly (p<0.001) higher than mean Post- dialytic systolic Blood Pressure 139.41 ± 20.74 mmHg of Hypotensive group. Mean Post-dialytic systolic Blood Pressure for Normotensive group was 139.41 ± 21.38 mmHg which was comparable (p>0.05) to mean Post-dialytic systolic Blood Pressure 139.41 ± 20.74 mmHg of Hypotensive group. Mean Post-dialytic systolic blood pressure for Hypotensive group was 145.88 ± 22.06 mmHg which was Significantly (p<0.05) higher than mean Post- dialytic systolic Blood Pressure 139.41 ± 20.74 mmHg of Normotensive group. Mean Post-dialytic diastolic Blood Pressure of Hypertensive group, Normotensive group and Hypotensive group was comparable (p>0.05). Mean of average intradialytic variability for systolic blood pressure at each point of measurement was higher for Normotensive group and lower for Hypotensive group but comparable in all three study groups (p>0.05). Mean of average intradialytic variability for diastolic at each point of measurement was higher for Hypotensive group and lower for Normotensive group but comparable in all three study groups (p>0.05). Conclusion: As far as morbidity in terms of abnormal 2D ECHO findings is concerned Hypotensive group of patients showed the significantly greater number of abnormalities among three groups. Although both Hypertensive and Hypotensive group had more abnormalities in 2D ECHO compared to the Normotensive group. The left ventricular hypertrophy, Pericardial effusion and signs of Pulmonary hypertension were in significantly higher in Hypertensive group. While Aortic regurgitation, Diastolic dysfunction and Tricuspid valve regurgitations were observed in significantly higher proportion in both Hypertensive and Hypotensive groups compared to the Normotensive. Overall death rate was 12.07% in our study which was significantly higher in Hypotensive group of patients. Although the most common cause of death was infection and cardiac causes accounted for second most common cause, vascular deaths were in significantly higher proportion among Hypotensive group of patients where causes for cardiopulmonary arrest were High ventricular rate, Myocardia ischemia, sudden cardiac arrest, Ventricular fibrillation, and ischemic cerebrovascular accident following Atrial fibrillation respectively.