Echocardiographic Patterns in Severe Chronic Kidney Disease with Type 4 Cardiorenal Syndrome Patients

Changes in cardiac structure and function detected by echocardiography are common in patients with type 4 cardiorenal syndrome and have been recognized as key outcome predictors. This study aimed to evaluate echocardiographic patterns in severe chronic kidney disease CKD in type 4 cardiorenal syndrome patients. This was a descriptive type of crosssectional study. The study was carried out in the Cardiology and Nephrology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka. After exclusion total of 44 patients having severe CKD (GFR <30 ml/min/1.73 m2) with type 4 cardiorenal syndrome were included in this study. All patients underwent echocardiography. Most of the patients with type 4 cardiorenal syndrome were in the 6th decade (Mean age was 58.9±5.9 (SD)in severe CKD with male predominant. Ischemic heart disease(65.9%), arrhythmia(13.63%), and heart failure(22.72%) were significantly noted in severe CKD in type 4 cardiorenal syndrome patients. Mean systolic blood pressure was 178.2±18.7 mmHg & mean diastolic blood was 97.7±5.9 mmHg among the study subjects. Left ventricular hypertrophy (54.6%), systolic dysfunction (27.3%), pericardial effusion (36.4%), valvular calcification (63.6%), and diastolic dysfunction (54.5%) were most common finding in severe CKD with type 4 cardiorenal syndrome. The study recommended that a Careful analysis of echocardiographic findings in patients with type 4 cardiorenal syndrome may discover the signs of cardiovascular changes. Thus appropriate measures can be taken. From this current study, it is evident that most of the patients with type 4 CRS with severe CKD developed left ventricular hypertrophy, so periodic 24- hour ambulatory blood pressure monitoring may be advised to address the unusual rise of blood pressure and treat it properly.