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Electrocardiographic abnormalities among dialysis naïve chronic kidney disease patients in Ilorin Nigeria
Background: Chronic kidney disease (CKD) has an increased risk of not only end-stage renal disease (ESRD), but majority of moderate CKD patients do die from cardiovascular disease (CVD) before reaching ESRD. The prognosis of these patients is very poor in most developing countries because of late pr...
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Published in: | Annals of African medicine 2012-01, Vol.11 (1), p.21-26 |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Background: Chronic kidney disease (CKD) has an increased risk of not
only end-stage renal disease (ESRD), but majority of moderate CKD
patients do die from cardiovascular disease (CVD) before reaching ESRD.
The prognosis of these patients is very poor in most developing
countries because of late presentation, inadequate diagnostic
facilities, and inability to pay for treatment. Knowledge about CVD in
CKD is crucial because of unpredictable progressive nature of the
disease and increased risk of premature death from cardiovascular
events. We sought to determine prevalence and pattern of
electrocardiographic abnormalities in dialysis naïve CKD patients.
Materials and Methods: This is a 10-year prospective cross-sectional
study carried out at the University of Ilorin Teaching Hospital,
Ilorin. Patients were recruited from the nephrology clinic and renal
wards and all who met diagnostic criteria for stages 4 and 5 CKD were
included. All had their standard 12-lead electrocardiogram (ECG)
recorded and various findings were critically studied and interpreted
independently by two consultant physician including a cardiologist.
Data analysis was done using SPSS version 16. Results: Overall, 86% of
the patients had at least one form of ECG abnormality, with
hypertension (HTN) and anemia being the main contributory factors.
These include left ventricular hypertrophy (LVH) (27.6%), left atrial
enlargement (LAE) (21.6%), combination of LVH and LAE (17.2%), and
ventricular premature contractions (6%). Etiology of CKD appears to
have influence on ECG changes as prevalence of LVH and LAE were high
among hypertensive renal disease, chronic glomerulonephritis (CGN), and
diabetic nephropathy patients. Conclusion: LVH and LAE were very common
ECG abnormalities in our dialysis naïve CKD patients. HTN, CGN,
anemia, late presentation, and male gender appear to be the main risk
factors for the ECG abnormalities. There is need for gender-specific
intervention strategies directed at early detection and treatment of
HTN, anemia, and underlying kidney disease, especially in resource poor
nations where the burden of CKD is assuming epidemic proportion. |
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ISSN: | 1596-3519 0975-5764 |
DOI: | 10.4103/1596-3519.91011 |