The LEFT VENTRICULAR GEOMETRY AMONG CHRONIC KIDNEY DISEASE PATIENTS: THE ROLE OF ANEMIA
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Abstract
BACKGROUND: Anaemia and abnormal left ventricular (LV) geometric pattern are common findings in Chronic Kidney disease (CKD) patients.
OBJECTIVES: To assess LV geometric pattern and its relationship with anaemia among CKD patients.
METHODS: A cross sectional study of 163 subjects (102 and 61 CKD subjects with and without anaemia respectively). Echocardiography determined the LV geometric pattern while packed cell volume (PCV) levels determined anaemia.
RESULTS: The mean age of subjects with and without anaemia was 54.04 ± 14.47 and 54.92 ± 15.67 years respectively (p = 0.717) while the prevalence of LVH among the two groups was 68.8% and 57.9% respectively (p = 0.174). The most frequent LV geometry in both groups was concentric LVH (53.8% and 43.9% respectively). Prevalence of LV systolic dysfunction was 45%, higher among anaemic subjects (58(61.7%) vs 10(17.5%)) p < 0.001. There was a strong negative correlation between PCV and left ventricular mass index (r = -0.345, p = 0.001) among anaemic subjects, but weak positive correlation among patients without anaemia (r = 0.001, p = 0.993).
CONCLUSION: Anaemic CKD patients had a high prevalence of abnormal LV geometry with significant contribution from anaemia. Early management of anaemia may thus improve cardiovascular outcomes.
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Copyright (c) 2023 ADEOLA AJIBARE, Oluwaseye Oladimeji, Ayoola ODEYEMI, Abisola Iyayi, Alaba Oladimeji, Olufemi Ojo, Alaba Adebola, Jacob Awobusuyi, Adebowale Adekoya
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References
K/DOQI clinical practice guidelines for chronic
kidney disease: evaluation, classification, and
stratification. Am J Kidney Dis. 2002;39(2
Suppl 1):S1-266.
Akinsola W, Odesanmi WO, Ogunniyi JO,
Ladipo GO. Diseases causing chronic renal
failure in Nigerians--a prospective study of 100
cases. Afr J Med Med Sci. 1989;18(2):131-7.
Alebiosu CO, Ayodele OO, Abbas A, Olutoyin
A. Chronic renal failure at the Olabisi Onabanjo
University Teaching Hospital, Sagamu,
Nigeria. Afr Health Sci. 2006;6 3:132-8.
Stevens PE, Levin A. Evaluation and
management of chronic kidney disease:
synopsis of the kidney disease: improving
global outcomes 2012 clinical practice
guideline. Ann Intern Med. 2013;158(11):825-
Ulasi, II, Ijoma CK. The enormity of chronic
kidney disease in Nigeria: the situation in a
teaching hospital in South-East Nigeria. J Trop
Med. 2010;2010:501957.
Ulasi II, Ijoma CK, Onodugo O, Arodiwe EB,
Ifebunandu NA, Okoye JU. Towards
prevention of chronic kidney disease in Nigeria:
a community-based study in Southeast Nigeria.
Kidney International. 2013;3:195-201.
Levin A, Djurdjev O, Barrett BJ, Burgess E,
Carlisle EJF, Éthier J, et al. Cardiovascular
disease in patients with chronic kidney disease:
getting to the heart of the matter. Am J Kidney
Dis. 2001;38 6:1398-407.
Bayauli MP, Lepira FB, Kayembe PK,
M'Buyamba-Kabangu JR. Left ventricular
hypertrophy and geometry in type 2 diabetes
patients with chronic kidney disease. An
echocardiographic study. Cardiovasc J Afr.
;23(2):73-7.
Jesuorobo DE, Odia JO, Uchenna DI. Left
Ventricular Hypertrophy and Its Correlates in
Chronic Kidney Disease Patients in a Nigerian Tertiary Hospital. Int. J. Intern. Med.
;1:11-6.
Locatelli F, Pozzoni P, Vecchio LD, Tentori F.
Effect of anaemia on left ventricular
hypertrophy in end‐stage renal disease. Eur. J.
Heart Fail. Supplements. 2003;2:207-12.
Donne R, Foley R. Anaemia management and
cardiomyopathy in renal failure. Nephrol. Dial.
Transplant. 2002;17(SUPPL. 1):37-40.
Foley RN, Parfrey PS, Harnett JD, Kent GM,
Murray DC, Barre PE. The impact of anemia on
cardiomyopathy, morbidity, and and mortality
in end-stage renal disease. Am J Kidney Dis.
;28(1):53-61.
Foley RN, Parfrey PS, Harnett JD, Kent GM,
Murray DC, Barre PE. Impact of hypertension
on cardiomyopathy, morbidity and mortality in
end-stage renal disease. Kidney Int.
;49(5):1379-85.
Ijoma C, Ulasi I, Ijoma U, Ifebunandu N. High
Prevalence of Anemia in Predialysis Patients in
Enugu, Nigeria. Nephrology Research &
Reviews. 2010;2(1):61-5.
Ulasi, II, Arodiwe EB, Ijoma CK. Left
ventricular hypertrophy in African Black
patients with chronic renal failure at first
evaluation. Ethn Dis. 2006;16(4):859-64.
Di Lullo L, Gorini A, Russo D, Santoboni A,
Ronco C. Left Ventricular Hypertrophy in
Chronic Kidney Disease Patients: From
Pathophysiology to Treatment. Cardiorenal
Med. 2015;5(4):254-66.
Eckardt KU, Scherhag A, Macdougall IC,
Tsakiris D, Clyne N, Locatelli F, et al. Left
ventricular geometry predicts cardiovascular
outcomes associated with anemia correction in
CKD. J Am Soc Nephrol. 2009;20(12):2651-
Levin A, Thompson CR, Ethier J, Carlisle EJ,
Tobe S, Mendelssohn D, et al. Left ventricular
mass index increase in early renal disease:
impact of decline in hemoglobin. Am J Kidney
Dis. 1999;34(1):125-34.
Ajibare AO, Adekoya AO, Dada AO,
Fagbemiro EY, Odeyemi AS, Okogun EO, et
al. Cardiovascular Risk Factors: A Silent
Epidemic among Urban Adult Male Socialites.
J Epid Soc Nig. 2021;4(2):61-70.
Kouno T, Katsumata N, Mukai H, Ando M,
Watanabe T. Standardization of the body
surface area (BSA) formula to calculate the
dose of anticancer agents in Japan. Jpn J Clin
Oncol. 2003;33(6):309-13.Chobanian AV, Bakris GL, Black HR,
Cushman WC, Green LA, Izzo JL, Jr., et al.
Seventh report of the Joint National
Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood
Pressure. Hypertension. 2003;42(6):1206-52.
Heider JG, Boyett RL. The picomole
determination of free and total cholesterol in
cells in culture. J Lipid Res. 1978;19(4):514-8.
Lang RM, Badano LP, Mor-Avi V, Afilalo J,
Armstrong A, Ernande L, et al.
Recommendations for cardiac chamber
quantification by echocardiography in adults:
an update from the American Society of
Echocardiography and the European
Association of Cardiovascular Imaging. J Am
Soc Echocardiogr. 2015;28(1):1-39.e14.
Akinsola A, Durosinmi MO, Akinola NO. The
haematological profile of Nigerians with
chronic renal failure. Afr J Med Med Sci.
;29(1):13-6.
Singh AK, Szczech L, Tang KL, Barnhart H,
Sapp S, Wolfson M, et al. Correction of
anemia with epoetin alfa in chronic kidney
disease. N Engl J Med. 2006;355(20):2085-98.Adejumo OA, Okaka EI, Madumezia G,
Okwuonu CG, Ojogwu LI. Assessment of some
cardiovascular risk factors in predialysis
chronic kidney disease patients in Southern
Nigeria. Niger Med J. 2015;56(6):394-9.
Chijioke A, Makusidi AM, Kolo PM.
Electrocardiographic abnormalities among
dialysis naïve chronic kidney disease patients in
Ilorin Nigeria. Ann Afr Med. 2012;11(1):21-6.
Lepira FB, Mpembe CMB, Mbutiwi FIN,
Makulo JRR, Kayembe PK, Kajingulu FM, et
al. Comparison of the Performance of Three
Commonly Used Electrocardiographic Indexes
for the Diagnosis of Left Ventricular
Hypertrophy in Black Hypertensive Patients
with Reduced Kidney Function Managed at a
Tertiary Healthcare Hospital: A Post-Hoc
Analysis. World J Cardiovasc. 2017;07:105-18.
Foppa M, Duncan BB, Rohde LE.
Echocardiography-based left ventricular mass
estimation. How should we define
hypertrophy? Cardiovasc Ultrasound.
;3:17.