IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 5 Ser. 10 (May. 2019), PP 12-17 www.iosrjournals.org DOI: 10.9790/0853-1805101217 www.iosrjournals.org 12 | Page Study of Cardiac Dysfunction in Patients of Chronic Kidney Disease Bibhu Prasad Behera 1 , R. Mohanty 2 1 Assistant Professor, Department of General Medicine, S.L.N. Medical College, Koraput, ODISHA 2 Associate Professor, Department of General Medicine, S.C.B. Medical College, Cuttack, ODISHA * Corresponding Author: Dr. Bibhu Prasad Behera Abstract The present study was undertaken to assess the prevalence of systolic and diastolic dysfunction, to determine the prevalence of left ventricular hypertrophy (LVH) from left ventricular mass index (LVMI), to correlate the degree of cardiac dysfunction with severity of chronic kidney disease (CKD) by echocardiography in patients of CKD on conservative management. Material & method: 75 CKD patients were taken in the study which were divided into three groups - Group A  Age and sex matched healthy controls (n=20). Group B  Patients with mild to moderate CRF (n=45) (S. Creatinine =1.5-6.0 mg/dl). Group C  Patients with severe CRF (n=30) (S. Creatinine > 6.0 mg/dl). Results: The prevalence of LVH along with systolic dysfunction was 10.0% (p<0.2653) in severe CRF (group C), higher than mild/moderate CRF (group B) which was 2.2% (p<1.0). The prevalence of LVH along with diastolic dysfunction was 76.7% (p<0.0001) in group C, which was significantly higher than group B which was 44.4% (p<0.0001). 51.1% (p<0.0001) patients were found to have LVH in mild to moderate CRF (group B) and 76.7% (p<0.0001) of patients had LVH in severe CRF (group C). 48.9% patients had concentric LVH in group B and 73.3% had concentric LV hypertrophy in group C. In diabetic CRF patients LV dysfunction was predominantly diastolic irrespective of the degree of LV hypertrophy. Conclusion: Systolic dysfunction was well preserved in majority cases of CKD as found from the Ejection Fraction and Fractional Shortening parameter whereas diastolic dysfunction was more commonly found in CKD patients. Key words: chronic kidney disease, left ventricular hypertrophy, left ventricular mass index systolic dysfunction, diastolic dysfunction. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 07-05-2019 Date of acceptance: 23-05-2019 --------------------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Chronic kidney disease (CKD) is a state of irreversible impairment of renal function which is a public health problem worldwide, with adverse outcomes of renal failure, cardiovascular disease and premature death. (1) Cardiovascular disease is the foremost cause of morbidity and mortality in patients of chronic kidney disease at every stage. Advanced cardiovascular complications are already present in 30-45% of CKD patients reaching ESRD. (2) It is now well recognised that chronic kidney disease (CKD), when present in patients with HF, independently predicts poor outcomes. (3,4) JNC-7 report has recognised CKD as an independent cardiovascular risk state. (3, 5) Cardiac disease is the leading cause of mortality in dialysis patients accounting for 40% of deaths in international registries. (6, 7) Left ventricular hypertrophy is the most common finding in the cardiovascular system, but there is no clear data about the prevalence of left ventricular systolic and diastolic dysfunction. (6,8) LVH is common in moderate to severe CRF. Cardiac disease frequently predates the start of dialysis. Echocardiography if performed early in the course of CRF may be valuable in the monitoring of therapy of these patients. (6, 9) Cardiac disease is commonly found in patients around the time of beginning of dialysis, but there is little data on the prevalence and natural history of cardiac function in the indivisuals with milder degrees of chronic renal failure. Furthermore, early detection and management of cardiac dysfunction will improve outcome in patients of CKD. Methods: - The study was undertaken at S.C.B. Medical College and Hospital, Cuttack, Odisha during the period from September 2011 to September 2012. All patients of Chronic Kidney Disease admitted to Postgraduate Department of Medicine and satisfying the following criteria were included in the study. Criteria for diagnosis of Chronic Kidney Disease was as given by- National kidney foundation: K/DOQI clinical practice guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification. (1) CKD is defined as the presence, for at least 3 months, of evidence of kidney damage with an abnormal GFR or alternatively, by a GFR < 60 ml/min /1.73m 2 BSA. (1)