Changes of electrocardiography in clinical outcomes of chronic kidney disease: a retrospective study



Research Article                

American Journal of BioMedicine

Volume 11, Issue 4, 2023, Pages 199-211      10.18081/2333-5106/2023.11/199

Hanan Slimani 1 , Kenton Zehr 2 , Nicolas Zouain 2 , Douglas Hainz * 

Received 19 July 2023; revised 29 September 2023; accepted 20 October 2023; published 25 December 2023


Abstract

Chronic Kidney disease (CKD) is a well-established major public health problem globally. CKD has been associated with increased morbidity, mortality, and rate of hospitalization, CKD is associated with increased risk of CVDs and associated mortality. Patients with CKD have multiple comorbidities and they have well-established risks that increase the risk of CVDs that may progress to end-stage renal disease (ESRD), where the kidneys are as of now not ready to satisfy the needs of the body. Both CKD and ESRD are related to an expanded gamble of cardiovascular infections (CVDs). Electrocardiographic (ECG) changes are extremely normal in patients with renal illness, particularly in those cases who have laid out CVDs. The ECG irregularities can have a likely relationship with the different reasons for CKD and can be related to different clinical results. This study aims to compare ECG abnormalities in 310 patients with CKD compared to 111 patients without CKD. The average age of the patients was 58±13.2 years with 88 females and 199 males and 250 patients having end-stage renal failure (ESRD). The resulting data showed that ECG changes revealed that 21 patients had ischemia changes (IHD), 15 had q-wave positive changes, and 65 had left ventricular hypertrophy (LVH). In conclusion, the ECG is recommended as a routine investigation in CKD/ESRD patients with DM and HTN. Moreover, evaluations should be performed based on physical examination and plans of care even when the ECG finding is negative.

Keywords: End-stage renal failure (ESRD); ECG abnormalities; Ischemia heart disease

Copyright © 2023 Hainz et al. This article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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1. Manns L, Scott-Douglas N, Tonelli M, Weaver R, Tam-Tham H, Chong C, et al. A population-based analysis of quality indicators in CKD. Clin J Am Soc Nephrol. 2017;12(5):727-733.
https://doi.org/10.2215/CJN.08720816
2. Coresh J, Selvin E, Stevens LA, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038-2047.
https://doi.org/10.1001/jama.298.17.2038
3. Nankivell BJ, Kuypers DR. Diagnosis and prevention of chronic kidney allograft loss. Lancet. 2011; 378: 1428.
https://doi.org/10.1016/S0140-6736(11)60699-5
4. Hsu CY, Vittinghoff E, Lin F, Shlipak MG. The incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency. Ann Intern Med. 2004;141(2):95-101.
https://doi.org/10.7326/0003-4819-141-2-200407200-00007
5. Plantinga LC, Boulware LE, Coresh J, et al. Patient awareness of chronic kidney disease: trends and predictors. Arch Intern Med. 2008;168(20): 2268-2275.
https://doi.org/10.1001/archinte.168.20.2268
6. Tsiachris D, Chrysohoou C, Oikonomou E, et al. Distinct role of electrocardiographic criteria in echocardiographic diagnosis of left ventricular hypertrophy according to age, in the general population: the ikaria study. J Hypertens. 2011; 29: 1624.
https://doi.org/10.1097/HJH.0b013e3283487780
7. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-272.
https://doi.org/10.1016/S0140-6736(13)60687-X
8. Okin PM, Devereux RB, Nieminen MS, et al. Electrocardiographic strain pattern and prediction of cardiovascular morbidity and mortality in hypertensive patients. Hypertension. 2004; 44: 48.
https://doi.org/10.1161/01.HYP.0000132556.91792.6a
9. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150.
10. Zhang ZM, Prineas RJ, Case D, et al. Gender differences between the minnesota code and novacode electrocardiographic prognostication of coronary heart disease in the cardiovascular health study. Am J Cardiol. 2011; 107: 817.
https://doi.org/10.1016/j.amjcard.2010.11.004
11. Mills KT, Xu Y, Zhang W, et al. A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney Int. 2015;88(5):950-957.
https://doi.org/10.1038/ki.2015.230
12. Rigatto C, Sood MM, Tangri N. Risk prediction in chronic kidney disease: pitfalls and caveats. Curr Opin Nephrol Hypertens. 2012;21(6):612-618.
https://doi.org/10.1097/MNH.0b013e328359072f
13. Thygesen K, Alpert JS, White HD. Joint ESC/ACCF/AHA/WHF Task force for the redefinition of myocardial infarction. Universal definition of myocardial infarction. Eur Heart J. 2007; 28: 2525.
https://doi.org/10.1093/eurheartj/ehm355
14. Echouffo-Tcheugui JB, Kengne AP. Risk models to predict chronic kidney disease and its progression: a systematic review. PLoS Med. 2012;9(11):e1001344.
https://doi.org/10.1371/journal.pmed.1001344
15. Genovese G, Friedman DJ, Ross MD, et al. Association of trypanolytic ApoL1 variants with kidney disease in African Americans. Science. 2010; 329(5993):841-845.
https://doi.org/10.1126/science.1193032
16. Woo YM, McLean D, Kavanagh D, et al. The influence of pre-operative electrocardiographic abnormalities and cardiovascular risk factors on patient and graft survival following renal transplantation. J Nephrol. 2002; 15: 380.
17. Tzur S, Rosset S, Shemer R, et al. Missense mutations in the APOL1 gene are highly associated with end stage kidney disease risk previously attributed to the MYH9 gene. Hum Genet. 2010;128 (3):345-350.
https://doi.org/10.1007/s00439-010-0861-0
18. Das MK, Khan B, Jacob S, Kumar A, Mahenthiran J. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation. 2006; 113: 2495.
https://doi.org/10.1161/CIRCULATIONAHA.105.595892
19. Tangri N, Kitsios GD, Inker LA, Griffith J, Naimark DM, Walker S, et al. Risk prediction models for patients with chronic kidney disease: a systematic review. Ann Intern Med. 2013;158(8):596-603.
https://doi.org/10.7326/0003-4819-158-8-201304160-00004
20. Naik RP, Derebail VK, Grams ME, et al. Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans. JAMA. 2014;312(20):2115-2125.
https://doi.org/10.1001/jama.2014.15063
21. Tangri N, Grams ME, Levey AS, Coresh J, Appel LJ, Astor BC, et al. Multinational assessment of accuracy of equations for predicting risk of kidney failure: a meta-analysis. JAMA. 2016;315(2):164-174.
https://doi.org/10.1001/jama.2015.18202
22. Kjeldsen SE, Dahlöf B, Devereux RB, et al. Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: a losartan intervention for endpoint reduction (LIFE) substudy. JAMA. 2002; 25: 1491.
https://doi.org/10.1001/jama.288.12.1491
23. O'Seaghdha CM, Parekh RS, Hwang SJ, et al. The MYH9/APOL1 region and chronic kidney disease in European-Americans. Hum Mol Genet. 2011;20 (12):2450-2456
https://doi.org/10.1093/hmg/ddr118
24. Morita H, Wu J, Zipes DP. The QT syndromes: long and short. Lancet. 2008; 372: 750.
https://doi.org/10.1016/S0140-6736(08)61307-0
25. Grams ME, Rebholz CM, Chen Y, et al. Race, APOL1 risk, and eGFR decline in the general population. J Am Soc Nephrol. 2016;27(9):2842-2850.
https://doi.org/10.1681/ASN.2015070763
26. Tangri N, Ferguson T, Komenda P. Pro: risk scores for chronic kidney disease progression are robust, powerful and ready for implementation. Nephrol Dial Transplant. 2017;32(5):748-751.
https://doi.org/10.1093/ndt/gfx067
27. Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA. The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med. 2003; 115: 171.
https://doi.org/10.1016/S0002-9343(03)00355-3
28. Peralta CA, Vittinghoff E, Bansal N, et al. Trajectories of kidney function decline in young black and white adults with preserved GFR: results from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Am J Kidney Dis. 2013;62(2):261-266.
https://doi.org/10.1053/j.ajkd.2013.01.012
29. Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE. Functional status of elderly adults before and after initiation of dialysis. N Engl J Med. 2009;361(16):1539-1547.
https://doi.org/10.1056/NEJMoa0904655
30. Terasaki PI, Cecka JM, Gjertson DW, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med. 1995;333(6):333-336.
https://doi.org/10.1056/NEJM199508103330601
31. Nicoll R, Robertson L, Gemmell E, Sharma P, Black C, Marks A. Models of care for chronic kidney disease: a systematic review. Nephrology (Carlton) 2018;23(5):389-396.
https://doi.org/10.1111/nep.13198
32. Mange KC, Joffe MM, Feldman HI. Effect of the use or nonuse of long-term dialysis on the subsequent survival of renal transplants from living donors. N Engl J Med. 2001;344(10):726-731.
https://doi.org/10.1056/NEJM200103083441004
33. Cooper BA, Branley P, Bulfone L, et al.; IDEAL Study. A randomized, controlled trial of early versus late initiation of dialysis. N Engl J Med. 2010;363 (7):609-619.
https://doi.org/10.1056/NEJMoa1000552
34. Eckardt KU, Bansal N, Coresh J, et al.; Conference Participants. Improving the prognosis of patients with severely decreased glomerular filtration rate (CKD G4+): conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2018;93(6): 1281-1292.
https://doi.org/10.1016/j.kint.2018.02.006
35. Allen AS, Forman JP, Orav EJ, Bates DW, Denker BM, Sequist TD. Primary care management of chronic kidney disease. J Gen Intern Med. 2011;26(4):386-392.
https://doi.org/10.1007/s11606-010-1523-6
36. Smekal MD, Tam-Tham H, Finlay J, et al. Patient and provider experience and perspectives of a risk-based approach to multidisciplinary chronic kidney disease care: a mixed methods study. BMC Nephrol. 2019;20(1):110.
https://doi.org/10.1186/s12882-019-1269-2
37. Arora P, Vasa P, Brenner D, Iglar K, McFarlane P, Morrison H, et al. Prevalence estimates of chronic kidney disease in Canada: results of a nationally representative survey. CMAJ. 2013;185(9):E417-E423.
https://doi.org/10.1503/cmaj.120833
38. Alberti H, Banner K, Collingwood H, Merritt K. 'Just a GP': a mixed method study of undermining of general practice as a career choice in the UK. BMJ Open. 2017;7(11):e018520.
https://doi.org/10.1136/bmjopen-2017-018520
39. Pianosi K, Bethune C, Hurley KF. Medical student career choice: a qualitative study of fourth-year medical students at Memorial University, Newfoundland. CMAJ Open. 2016;4(2):E147-E152.
https://doi.org/10.9778/cmajo.20150103
40. Donald M, King-Shier K, Tsuyuki RT, Al Hamarneh YN, Jones CA, Manns B, et al. Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study. CMAJ Open. 2017;5(1):E205-EE12.
https://doi.org/10.9778/cmajo.20160135

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Slimani H, Zehr K, Zouain N, Hainz D. Changes of electrocardiography in clinical outcomes of chronic kidney disease: a retrospective study. American Journal of BioMedicine 2023; 11(4):199-211.

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APA
Hanan Slimani, Kenton Zehr, Nicolas Zouain, Douglas Hainz. (2023). Changes of electrocardiography in clinical outcomes of chronic kidney disease: a retrospective study. American Journal of BioMedicine11(4), 199–211. doi:10.18081/2333-5106/2023.11/199
MLA
Hanan Slimani, Kenton Zehr, Nicolas Zouain, Douglas Hainz. “Changes of Electrocardiography in Clinical Outcomes of Chronic Kidney Disease: A Retrospective Study.” American Journal of BioMedicine, vol. 11, no. 4, Dec. 2023, pp. 199–211, doi:10.18081/2333-5106/2023.11/199
HARVARD
Hanan Slimani, Kenton Zehr, Nicolas Zouain, Douglas Hainz (2023) “Changes of electrocardiography in clinical outcomes of chronic kidney disease: a retrospective study,” American Journal of BioMedicine, 11(4), pp. 199–211. doi: 10.18081/2333-5106/2023.11/199.
VANCOUVER
Hanan Slimani, Kenton Zehr, Nicolas Zouain, Douglas Hainz. Changes of electrocardiography in clinical outcomes of chronic kidney disease: a retrospective study. American Journal of BioMedicine [Internet]. 2023 Dec 25;11(4):199–211. Available from: https://ajbm.net/research-article_122614html/

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