Ecg Changes In Patients With Chronic Kidney Disease According To Stage Of Disease —A Tertiary Care Hospital Study

Abstract

BACKGROUND  : Chronic kidney disease describes the gradual loss of kidney function for more than 3 months .  CKD is associated with an increased risk of cardiovascular disease and chronic renal failure. It can lead to end-stage kidney failure, which requires dialysis or transplant . It is estimated that the annual incidence of new cases of end-stage renal disease (ESRD) is >100 per million population in Pakistan. CKD is associated with wide range of ECG abnormalities .  

OBJECTIVE  :The purpose of our research was to study ECG abnormalities in patients with Chronic Renal failure presenting in Department Of Medicine Rawalpindi Medical University Allied Hospital Rawalpindi .

METHODOLOGY :  This cross sectional study was carried out  from August 2017 to November 2017 on patients presenting in Medicine departments of Allied hospital RMU Rawalpindi  with features suggestive of CKD. According to our reference study  And  WHO sample size calculator keeping level of significance 5 % our study sample size came out to be 94  .Our inclusion criteria was all CKD patients between age of 15 to 80 years with exclusion criteria of all those patients who have preexisting cardiac disease or pacemaker implantation. Data was analyzed in SPSS version 24 .

RESULTS  : Our total study comprised of 94 cases. Mean age was   48.6 .Out of which 49(52.1%) were males and 45 (47.9%) were females, 60(63.8%) had hypertension   , 31(33%) had Diabetes, 15(16%) were smokers . Out of 60   hypertensive   patients 27 were males while  females were 33   . 20   females  were diabetic while 11  males were. All  smokers were males. 49 patients had blood transfusion.50(53.2%) patients were on dialysis. 37 (39.4%) had no ECG changes ,16 (17%) had Tall T waves ,heart rate changes in 8 (8.5%) 5 had tachycardia while 3 had bradycardia, ,left ventricular hypertrophy in  7 (7.4 %) ,Prolong PR interval in 6 (6.4%) ,Prolong QT interval 4(4.3%) ,Broad QRS complex in 4 (4.3%) ,ST segment

depression in 4 (4.3%) ,inverted T wave in 3 (3.2%) ,ST segment depression and T wave inversion both were in 1 (1.1%) ,Short QT interval 1 (1.1%) ,ST segment elevation 1(1.1%) ,Right bundle branch block 1(1.1%)  and premature beats  in 1 (1.1%).

CONCLUSION   :  The most common ECG abnormality in CKD patients came out to be Tall T waves which shows electrolyte abnormalities are mostly evident in such patients.