Electrocardiographic abnormalities among late-stage non-dialysis chronic kidney disease patients
Eka P B Mulia1, Ricardo A Nugraha1, Maya Q A'yun1
1Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia.
Insights
ECG abnormalities are highly prevalent in patients with late-stage chronic kidney disease (CKD). Early screening for these cardiovascular issues in CKD patients is crucial to prevent complications and sudden cardiac death.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Cardiovascular disease (CVD) is a frequent complication in chronic kidney disease (CKD) patients.
- CKD patients face an elevated risk of sudden cardiac death due to the progressive nature of the disease.
- Understanding ECG abnormalities in CKD is vital for risk stratification and management.
Purpose of the Study:
- To investigate the prevalence and types of electrocardiogram (ECG) abnormalities in patients with late-stage, non-dialysis CKD.
- To identify common ECG findings associated with advanced CKD.
Main Methods:
- A descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia.
- 191 hospitalized patients with late-stage CKD (January-December 2019) were included.
- ECG interpretations were performed by a qualified cardiologist.
Main Results:
- 92.1% of patients exhibited at least one ECG abnormality.
- Common abnormalities included prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), and peaked T wave (22.0%).
- Prevalence of anemia (74.9%), hypertension (58.1%), and type 2 diabetes mellitus (39.3%) was high among participants.
Conclusions:
- ECG abnormalities are highly prevalent in non-dialysis, late-stage CKD patients.
- The findings underscore the significant impact of long-term CKD on cardiovascular disease pathogenesis and mortality.
- Routine ECG screening is recommended for Indonesian CKD patients at risk of cardiovascular complications.
Objectives:
Cardiovascular disease (CVD) complication is common among chronic kidney disease (CKD) patients. Thus, knowledge about CVD and ECG abnormalities in CKD are essential due to progressive nature of the disease and increased risk of sudden cardiac death. This study aims to scrutinize the ECG abnormalities among nondialysis late-stage CKD patients.
Methods:
A descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with late-stage CKD between 1 January and 31 December 2019, who were consulted at the department of cardiology and vascular medicine during their initial admission at emergency room. ECG interpretation for this study was done by qualified cardiologist.
Results:
There were 191 patients included in this study. Mean ages were 52.2 ± 11.8 years old and 51% were males. Total 143 (74.9%) patients had anemia, 111 (58.1%) had hypertension and 75 (39.3%) had type 2 diabetes mellitus. Mean serum creatinine was 10.5 ± 8.0 mg/dL. There were 176 (92.1%) patients with at least one form of ECG abnormalities. Prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), peaked T wave (22.0%) and left ventricular hypertrophy (16.7%) were the most common abnormalities.
Conclusions:
ECG abnormalities are common among nondialysis late-stage CKD patients. Given the fact that long-term CKD influences the pathogenesis cardiovascular diseases and substantial cardiovascular mortality, there is a need to screen Indonesian CKD patients who are at risks of getting earlier complications.
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