Prevalence and Predictors of Heart Failure among Patients on Maintenance Hemodialysis Therapy at Tertiary Care Hospitals
Jawad Abbas, Muhammad Arshad, Parveen Akhtar, Arshad Ali Shah, Syed Dilbahar Ali Shah, Khan Gul
874
ABSTRACT
Background and Aim: The
incidence of heart failure among hemodialysis patients predicts poor outcomes.
Hypertension, aging, and diabetes mellitus are traditional risk factors for
heart failure which may not predict heart failure accurately. Heart
failure might be caused by other factors. The present study aims to determine
the prevalence and predictors of heart failure among patients on maintenance
hemodialysis.
Methodology:
This cross-sectional study was
carried out on 142 hemodialysis patients in the department of Cardiology, PNS Shifa Hospital Karachi and King Abdullah Teaching hospital Mansehra
for duration of six months from 5th March 2021 to 4th
September 2021. All the patients having age above
16 years and who underwent at least three months of dialysis therapy were
enrolled. Patients with severe respiratory distress and mentally incapacitated
were excluded. Questionnaire-based Pro-forma was used for collecting patient’s
demographic details, clinical details such as human immunodeficiency virus (HIV)
disease, heart failure symptoms, hyperlipidemia, angina, and presence of
diabetes, etc., and dialysis-related clinical information. Stadiometer and
standard weight scale were used for height and post-dialysis weight also known
as dry weight respectively. A monthly dose of erythropoietin (EPO) was taken
from medical records. Based on the blood sample, albumin, ferritin, urea,
complete blood count, C-reactive protein (CRP), and total cholesterol were
measured. SPSS version 21 was used for data analysis.
Results:Out of 142
hemodialysis patients, 105 (73.9%) were male and 37 (26.1%) were females.
Overall mean age was 46.74 ± 11.62 years. Of the total 142 patients, the
prevalence of hypertension and diabetes mellitus was 138 (97.2%) and 73 (51.4%)
respectively. The incidence of heart failure was 21 (14.8%). The incidence of
hypertension, anemia, and angina were heart failure autonomousprognosticators
on multivariate analysis. A higher score of malnutrition inflammation and
resistance index for erythropoietin was found in heart failure patients.
Conclusion: Our
study found that heart failure is significantly associated with anemia, angina,
and hypertension in hemodialysis patients. Malnutrition–inflammation complex
and erythropoietin resistance were more prevalent in patients with heart
failure. These conditions necessitate a thorough cardiac evaluation and
appropriate treatment.
Keywords: Heart Failure,
Hemodialysis, Hypertension. Angina
ABSTRACT
Background and Aim: The
incidence of heart failure among hemodialysis patients predicts poor outcomes.
Hypertension, aging, and diabetes mellitus are traditional risk factors for
heart failure which may not predict heart failure accurately. Heart
failure might be caused by other factors. The present study aims to determine
the prevalence and predictors of heart failure among patients on maintenance
hemodialysis.
Methodology:
This cross-sectional study was
carried out on 142 hemodialysis patients in the department of Cardiology, PNS Shifa Hospital Karachi and King Abdullah Teaching hospital Mansehra
for duration of six months from 5th March 2021 to 4th
September 2021. All the patients having age above
16 years and who underwent at least three months of dialysis therapy were
enrolled. Patients with severe respiratory distress and mentally incapacitated
were excluded. Questionnaire-based Pro-forma was used for collecting patient’s
demographic details, clinical details such as human immunodeficiency virus (HIV)
disease, heart failure symptoms, hyperlipidemia, angina, and presence of
diabetes, etc., and dialysis-related clinical information. Stadiometer and
standard weight scale were used for height and post-dialysis weight also known
as dry weight respectively. A monthly dose of erythropoietin (EPO) was taken
from medical records. Based on the blood sample, albumin, ferritin, urea,
complete blood count, C-reactive protein (CRP), and total cholesterol were
measured. SPSS version 21 was used for data analysis.
Results:Out of 142
hemodialysis patients, 105 (73.9%) were male and 37 (26.1%) were females.
Overall mean age was 46.74 ± 11.62 years. Of the total 142 patients, the
prevalence of hypertension and diabetes mellitus was 138 (97.2%) and 73 (51.4%)
respectively. The incidence of heart failure was 21 (14.8%). The incidence of
hypertension, anemia, and angina were heart failure autonomousprognosticators
on multivariate analysis. A higher score of malnutrition inflammation and
resistance index for erythropoietin was found in heart failure patients.
Conclusion: Our
study found that heart failure is significantly associated with anemia, angina,
and hypertension in hemodialysis patients. Malnutrition–inflammation complex
and erythropoietin resistance were more prevalent in patients with heart
failure. These conditions necessitate a thorough cardiac evaluation and
appropriate treatment.
Keywords: Heart Failure,
Hemodialysis, Hypertension. Angina