To Study the Importance of Electrocardiographic and Echocardiographic Findings in Patient of Chronic Kidney Disease with Special Reference to Lipid Profile
Introduction: Dyslipidemia is one of the most common complications of chronic renal failure (CRF) reflected even in the early stages of CRF and usually parallels the deterioration in renal function. As a consequence, dyslipidemia as a risk factor in CKD progression should be explored and documented more. dyslipidemia in CKD patients may actively participate in the progression of cardiovascular disease (CVD) and in the deterioration of kidney function. In the general population, dyslipidemia is a known risk factor for CVD but the relationship of dyslipidemia as a risk factor in CKD progression should be explored and documented more. One of the most important pathophysiological mechanisms for CVD in patients with CKD is the widespread and possibly accelerated formation of atherosclerotic plaques due to hyperlipidemia, uremic toxins, inflammation, oxidative stress, and endothelial dysfunction. Recent studies showed that the level of oxidized low-density lipoprotein (LDL) cholesterol increases and high density lipoprotein (HDL) cholesterol dysfunction occurs as kidney function declines and inflammation becomes more pronounced. Aim & Objective: To study the pattern of involvement of cardiovascular system in CKD patients. Correlation of ECG and ECHO findings in hemodialysis and nonhemodialysis patients. To compare the lipid profile in chronic kidney disease patients with and without hemodialysis. Methodology: A detailed clinical history and physical examination will be done and findings will be recorded. All the patients in the study will be subjected to biochemical tests like, CBC, renal function tests, and ultrasonographic examination of abdomen to confirm the presence of end stage renal disease and to assess echocardiographic findings of heart. Patients attending the I.P.D. of General Medicine Subjects meeting the inclusion criteria shall be selected. Haemodialysis Patients Nonhaemodialysis Patients ECG, Lipid profile. Results: Among CKD patients with hemodialysis, most common ECG abnormality was LVH (n=38), followed by ST changes (n=26), 18 patients had QTc prolongation and P-mitrale or p- pulmonale and 8 patients had tall T wave. Out of 46 hypertension patients of CKD patients without hemodialysis, 24 had LVH in ECG while out of 71 hypertension patients of CKD patients with hemodialysis, 28 patients had LVH in ECG. This correlation between hypertension and LVH in CKD patients with and without hemodialysis came out to be statistically insignificant with chi square value 0.058 (with yates correction) and p value 0.81. Conclusion: CKD patients should undergo baseline and regular electrocardiography to screen for cardiovascular diseased as the earliest so that early intervention can be done. Echocardiography is better the electrocardiography in detecting LVH because LVH was detected in 46.3% CKD patients via echo while LVH was detected in 41.2% CKD patients via ECG. ECG showcases the heart's electrical system, whereas ECHO showcases the heart's mechanical system for further investigation and planning of the respective patient's treatment.
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Copyright (c) 2023 Pramod Singh Yadav, Kanika Sethi, J.S. Namdhari, Ramavtar Rawat, O.P. Jatav
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