Prevalence and Factors Associated with Left Ventricular Systolic Dysfunction in End-Stage Renal Disease Patients on Dialysis.

BACKGROUND

Heart failure is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Previous studies reported various factors associated with left ventricular systolic dysfunction (LVSD) in patients with ESRD.

OBJECTIVE

To investigate the prevalence and factors associated with LVSD in patients with ESRD on dialysis.

MATERIAL AND METHOD: Patients with ESRD on dialysis who underwent comprehensive transthoracic echocardiography at Siriraj Hospital between 2003 and 2014 were enrolled. LVSD was defined as left ventricular ejection fraction less than 40%.

RESULTS

One hundred sixty one patients with a mean age of 56.5±15.4 years were included and 46% were female. Regarding mode of dialysis, 25% and 75% of patients were on peritoneal dialysis and hemodialysis, respectively. Median duration of dialysis was three years. Smoking, diabetes, dyslipidemia, and hypertension were reported in 30%, 40%, 57%, and 94% of patients, respectively. History of heart failure and coronary artery disease (CAD) were reported in 23% and 24% of cases, respectively. Prevalence of LVSD was 5%. History of heart failure, known CAD, and left ventricular diastolic dimension (LVDd) were found to be univariately associated with LVSD. Multivariate factors associated with LVSD were known CAD (OR 23.67, 95% CI 1.23-456.54, p-value = 0.036) and LVDd (OR 1.56, 95% CI 1.15-2.11, p-value = 0.004).

CONCLUSION

Prevalence of LVSD in patients with ESRD on dialysis in the present study was 5%. Known CAD and LVDd were independent predictors of LVSD in this population.