Impact of haemodialysis on cardio-metabolic burden in chronic kidney disease patients - A prospective cohort study
Kalu Kalu Okorie1, Chikezie Hart Onwukwe2, Nkiru Ifeoma Chikezie3, Offia Kalu4, Charles Ukachukwu Osuji4
1 Cardiology Unit, Department of Medicine, Cedarcrest Hospitals, Gudu, Abuja, Nigeria
2 Division of Endocrinology and Diabetes, Department of Internal Medicine, Al Isawiya General Hospital, Ministry of Health, Directorate of Al Gurayat, Al Qurayyat, Kingdom of Saudi Arabia
3 Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra, Nigeria
4 Department of Internal Medicine, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra, Nigeria
Chikezie Hart Onwukwe
Al Isawiya General Hospital, Ministry of Health, Directorate of Al Gurayat, Al Qurayyat 77471
Kingdom of Saudi Arabia
Source of Support: None, Conflict of Interest: None
Background: Maintenance haemodialysis (MHD) is the major form of renal replacement therapy in Nigeria, and may have a significant impact on cardiovascular (CV) and metabolic burden in chronic kidney disease (CKD) patients.
Methods: This is a prospective cohort study involving 40 CKD dialysis-naïve end-stage renal disease patients who were assessed at first contact before commencing dialysis and assessments repeated 3 months later while on MHD. Clinical, echocardiographic and biochemical indices were assessed on both occasions. We studied the impact of MHD on CV risk factors such as left ventricular hypertrophy, left ventricular ejection fraction (LVEF), high calcium-phosphate product, hypoalbuminaemia, anaemia and dyslipidaemia.
Results: The mean serum calcium-phosphate product, plasma total cholesterol, triglycerides and low-density lipoprotein cholesterol were significantly higher at baseline than at three months; while the mean haemoglobin, serum albumin and plasma high-density lipoprotein were significantly lower at baseline than at 3 months (P < 0.01). There was a significant difference in echocardiographic indices at baseline and at 3 months in CKD patients on MHD. Left ventricular mass and left ventricular mass index were significantly higher at baseline than at 3 months (P < 0.01); while LVEF was significantly lower at baseline than at 3 months (P < 0.01).
Conclusion: Our study showed statistically significant improvements in CV risk factors among CKD patients after 3 months on maintenance haemodialysis. Early and effective maintenance haemodialysis reduce CV risk factors in Nigerian CKD patients.