Clinical and Echocardiographic Profile of Heart Disease in Pre and Post Dialysis Endstage Renal Disease Patients in North Bengal, India
Sourav Banerjee
North Bengal Medical College, Siliguri, India.
Indranil Sen *
North Bengal Medical College, Siliguri, India.
Pasang Lahmu Sherpa
North Bengal Medical College, Siliguri, India.
Tista Har
North Bengal Medical College, Siliguri, India.
Dipanjan Bandyopadhyay
North Bengal Medical College, Siliguri, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Cardiovascular abnormalities are common in patients with end-stage renal disease and may be influenced by volume overload, hypertension, anaemia, uraemic milieu, and initiation of haemodialysis. This study evaluated the clinical and echocardiographic profile of patients with end-stage renal disease before and after initiation of maintenance haemodialysis in a tertiary care setting in North Bengal.
Methods: This prospective observational longitudinal study included 90 patients aged 18–50 years with established end-stage renal disease who were initiated and maintained on haemodialysis at the Department of Medicine, North Bengal Medical College, Darjeeling. Clinical evaluation, laboratory investigations, and transthoracic two-dimensional echocardiography were performed at baseline before dialysis initiation, at 1 month, and at 3 months after initiation of haemodialysis.
Results: The mean age of the study population was 41.5 ± 6.85 years, and 52 patients were male. Hypertension was present in 86 patients and diabetes mellitus in 63 patients. Left ventricular mass index decreased from 129.51 ± 39.70 g/m² at baseline to 126.60 ± 39.84 g/m² at 3 months. Left ventricular end-systolic volume decreased from 57.16 ± 24.14 ml to 55.93 ± 23.19 ml, while left ventricular ejection fraction increased from 55.04 ± 11.51% to 55.67 ± 11.10%. Left ventricular end-diastolic volume and left atrial diameter remained relatively stable. Haemoglobin increased, while blood urea and serum creatinine decreased during follow-up.
Conclusion: Initiation of haemodialysis was associated with improvement in selected biochemical and echocardiographic parameters over 3 months. Regular cardiovascular assessment may help guide monitoring and management in this patient population.
Keywords: End-stage renal disease, haemodialysis, echocardiography, left ventricular hypertrophy, left ventricular mass index, left ventricular ejection fraction, left ventricular end-systolic volume, anaemia, hypertension, diabetes mellitus, North Bengal