Left ventricular systolic function in a Nigerian pre-dialysis patient population with chronic kidney disease

This study evaluates left ventricularsystolic function (LVSF) and factors affecting it in CKD patients at first presentation, using two dimensional echocardiography.

One hundred consecutive patients with CKD who were presenting to the medical outpatient and renal clinics of university of Nigeria teaching hospital, Enugu for the first time, who satisfied the study criteria were screened. Eighty six patients completed the study. Forty-eight sex matched hypertensive patients with normal renal function and forty-six age and sex matched subjects (with normal blood pressure and renal function) were selected as controls. Clinical and laboratory parameters and echocardiographic indices were measured.

Left ventricular systolic dysfunction (LVSD) was present in 13 (15.1%) of CKD patients and 4 (8.3%) of hypertensive patients (p < 0.001). The mean fractional shortening in CKD patients (35.1 +/- 10.4%) was significantly lower than the hypertensive patients (40.1 +/- 9.8), p = 0.008. Positive correlation was found between fractional shortening (FS) and estimated glomerular filtration rate, haemoglobin level, CKD stage, diastolic blood pressure, serum albumin and systolic blood pressure.(r = 0.281, P < 0.001; r = 0.277, p < 0.001; r = 0.270, p = < 0.001; r = 0.237; P = 0.001; r = 0.230, p = 0.002; and r = 0.199, p = 0.007) respectively. Left ventricular mass index and mean arterial blood pressure, correlated negatively with LV systolic function (r = -0.315, P < 0.001; and r = -0.223, P Stepwise multiple regression analysis showed that of all the factors that correlated with LVSF.

This study has shown that LVSF is impaired in a significant number of our CKD patients at presentation.