Spectrum of echocardiographic abnormalities in end-stage renal disease patients undergoing hemodialysis

Background: Cardiovascular disease is the most common cause of mortality in patients with end-stage renal disease. Determining the spectrum of echocardiographic abnormalities in these patients can help the prevention of mortality in this group of chronically ill patients. Methods: 123 adult patients with chronic renal failure who underwent hemodialysis and echocardiography during February till November 2006 were enrolled. Complete 2-D, M-mode, Doppler and color Doppler study were performed by a single operator for each patient and the abnormalities were recorded. Results: The mean age was 38.3+13 and 61.5 % were female. The mean cardiac dimensions were right ventricular diastolic dimension: 1.89+0.05 cm, inter-ventricular septal dimension: 1.3+1.23 cm, enddiastolic dimension: 6.1+0.6 cm, endsystolic dimention: 3.84+2.5 cm, ejection fraction: 59.2+11 %, left ventricular mass: 238+90 gr. The prevalence of LV systolic dysfunction (EF < 50 %) was 20.3%, valvular regurgitation > mild, mitral regurgitation: 52.8%, aortic regurgitation: 24.4%, and tricuspid regurgitation: 35.8%. Valvular calcification was seen in 14.5% of the patients but no significant stenosis was noted. The prevalence of pulmonary hypertension (SPAP>30 mm Hg) was 14.7% and that of pericardial effusion (> mild) was 14.7%. Cardiac ejection fraction was lower in patients requiring more hemodialysis sessions (p value <0.036). Conclusion: Echocardiographic abnormalities are very common in patients suffering from end-stage renal disease (ESRD), so periodic echocardiographic examination for diagnosis and treatment of cardiac abnormalities is highly recommended.