CORRELATION OF LEFT ATRIAL VOLUME INDEX AND E-GFR IN PATIENTS OF CHRONIC KIDNEY DISEASE AT A TERTIARY CARE CENTRE
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Keywords
Left Atrial Volume Index, Chronic Kidney Disease, End-Stage Renal Disease, Left Ventricular Systolic Dysfunction, Echocardiography.
Abstract
Background: Chronic kidney disease patients have an increased risk of cardiovascular morbidity and mortality. LAVI (Left Atrial Volume Index) serves as an indicator of left ventricular diastolic dysfunction and is part of the cardiac remodeling process seen in various cardiovascular diseases. Studies have shown that left atrial dilatation correlates with the progression of left ventricular dysfunction, making it crucial to monitor cardiovascular health in CKD patients, especially in those awaiting renal transplantation.
Methods: A total of 100 CKD patients (outpatients and inpatients) from hospitals affiliated with BMCRI were included. The study was conducted through history, physical examination, renal function tests, and 2D echocardiography. The patients were evaluated based on their e-GFR (estimated Glomerular Filtration Rate), clinical stage of CKD, and echocardiographic parameters, including LAVI, LVSD (Left Ventricular Systolic Dysfunction), and hypertrophy.
Results: The mean serum urea level was 88.52 ± 48.44 mg/dL. The majority of patients (61%) were in Stage 5 CKD, with 60% undergoing hemodialysis. Echocardiographic findings showed that 99% of patients had LVSD, and 53% exhibited left ventricular hypertrophy. The LAVI was significantly higher in patients on hemodialysis (p=0.01) and increased with the worsening CKD stage (p=0.003). There was a strong correlation between LAVI and LVSD (p=0.001), and hypertension further worsened LVSD (p=0.038).
Conclusion: Patients with CKD stages 3-5 exhibit an increased LAVI, indicating left atrial enlargement and dysfunction. Early screening using echocardiography in these patients can help assess cardiovascular risk, allowing for timely interventions to mitigate cardiovascular disease and improve patient outcomes.
References
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Dr. Babu Sunil Kiran K.L.
Associate Professor, Department of General Medicine, BGS MCH Hospital, Bangalore, Karnataka, India.
Dr. Mithil Jagannath
Senior Resident, Department of General Medicine, BGS MCH Hospital, Bangalore, Karnataka, India.
Dr. Santosh Kumar S.B.
Assistant Professor, Department of General Medicine, BGS MCH Hospital, Bangalore, Karnataka, India.
Dr. Saqlain N.M.
Associate Professor, Department of General Medicine, BGS MCH Hospital, Bangalore, Karnataka, India.