Cardiac complications in chronic hemodialysis : about 36 cases at the Military Hospital of Nouakchott (Mauritania)

Abstract

Introduction Cardiovascular complications are the leading cause of morbidity and mortality in hemodialysis patients; they are related to the multitude of conventional cardiovascular risk factors and speci ic state of uremic patients with renal impairment. The objectives of this study is to evaluate the frequency of cardiovascular risk factors in a population of hemodialysis and searching for a correlation between the installation of cardiac complications irstly the number of cardiovascular risk factors, and secondly with seniority on dialysis. Method: This is a descriptive study and retroprospective spread over 6 months (January 1st 2018 to June 30th 2018) of hemodialysis patients, the Nouakchott Military Hospital all patients have bene ited from a Doppler ultrasound of the heart with measurement of various cardiac parameters (the diameter of the left atrium, diameter left ventricular on diastole, the measurement of the illing pressure of the left ventricle, the measurement of the systolic function of the left ventricle, the gradient OG / VG, and VG / AO, the pressure of the systolic pulmonary artery), a laboratory tests (CBC, urea, creatinine blood glucose, blood electrolytes, serum calcium, serum phosphate, LDL‑C HDL‑C, TG, and an electrocardiogram. patients were dialysis 3 times / week for 4 hours. The search for correlations between installation cardiac complications with chronicity on dialysis and with the number of risk factors was sought through the pricing program. Page 88 Diop El M. et al. Les complications cardiaques chez les hémodialysés chroniques à propos de 36 cas à l’hôpital Militaire de Nouakchott. Mauritanie Médicale Janvier 2020; 3, Vol1 : 087 092 Results In total we have 36 patients studied, 20 men and 16 women, aged between 23 and 75years. The average age is 45 years. The average length on dialysis was 3.6 years. Patients from Trarza represented 25% of cases, those from Atar was 22.22%. found cardiac risk factors are: hypertension in 52.7% of cases, Tobacco in 19% cases, the diabète14%, the diabetes association and hypertension in 14% of patients. The one factor cardiovascular risk accounted for 27.7% of cases, two risk factors associated in 22.2% of cases, three factors were associated with 6.66% of cases; 8.3% of patients had 4 associated risk factors and patients without cardiac risk factors found in 25% of cases. The electrical anomalies found are: ventricular hypertrophy in 81% of cases, ischemic lesions in 38% of cases, arrhythmias supraventricular atrial ibrillation type from 5.55%. The heart abnormalities observed in cardiac Doppler ultrasound are: Left ventricular hypertrophy in 83% of cases, pulmonary arterial hypertension in 61% of cases, diastolic dysfunction in 42% of cases, dilatation of the left atrium in 38% of cases, systolic dysfunction in 32% of cases, dilatation of the left ventricle in 22% of cases. The patients were dialyzed 3 times / week for 4 hours. Chronic glomerulonephritis was the most common cause found with 41.6% of cases. Conclusion: Cardiac complications are the leading causes of mortality in hemodialysis, specially the left ventricular hypertrophy; hence the importance of treatment and early monitoring and suitable risk factors for this group of highly vulnerable patients