Clinical and Echocardiographic Profile of Heart Disease in Pre and Post Dialysis Endstage Renal Disease Patients in North Bengal, India

Abstract

Background: Cardiovascular abnormalities are common in patients with end-stage renal disease and may be influenced by volume overload, hypertension, anaemia, uraemic milieu, and initiation of haemodialysis. This study evaluated the clinical and echocardiographic profile of patients with end-stage renal disease before and after initiation of maintenance haemodialysis in a tertiary care setting in North Bengal. Methods: This prospective observational longitudinal study included 90 patients aged 18–50 years with established end-stage renal disease who were initiated and maintained on haemodialysis at the Department of Medicine, North Bengal Medical College, Darjeeling. Clinical evaluation, laboratory investigations, and transthoracic two-dimensional echocardiography were performed at baseline before dialysis initiation, at 1 month, and at 3 months after initiation of haemodialysis. Results: The mean age of the study population was 41.5 ± 6.85 years, and 52 patients were male. Hypertension was present in 86 patients and diabetes mellitus in 63 patients. Left ventricular mass index decreased from 129.51 ± 39.70 g/m² at baseline to 126.60 ± 39.84 g/m² at 3 months. Left ventricular end-systolic volume decreased from 57.16 ± 24.14 ml to 55.93 ± 23.19 ml, while left ventricular ejection fraction increased from 55.04 ± 11.51% to 55.67 ± 11.10%. Left ventricular end-diastolic volume and left atrial diameter remained relatively stable. Haemoglobin increased, while blood urea and serum creatinine decreased during follow-up. Conclusion: Initiation of haemodialysis was associated with improvement in selected biochemical and echocardiographic parameters over 3 months. Regular cardiovascular assessment may help guide monitoring and management in this patient population.