Echocardiographic Assessment of Left Ventricular Function in Patients with Chronic Kidney Disease: A Cross-sectional Study at a Tertiary Hospital in Chennai, India

Abstract

Background: Chronic kidney disease (CKD) is a major global public health problem and is associated with a markedly increased risk of cardiovascular morbidity and mortality. Cardiovascular disease remains the leading cause of death in patients with CKD, with left ventricular (LV) dysfunction representing one of the earliest and most significant cardiac manifestations. Echocardiography is a non-invasive, reliable, and widely available imaging modality for early detection and assessment of these abnormalities. However, local evidence describing the pattern of LV systolic and diastolic dysfunction across CKD stages 3–5 and its clinical and biochemical correlates remains limited. Objectives: To determine the prevalence and echocardiographic patterns of left ventricular dysfunction among patients with CKD stages 3–5 and to identify the clinical and biochemical factors associated with LV dysfunction. Methods: This cross-sectional study included 104 adult patients with CKD stages 3–5 attending a tertiary care hospital in Chennai. Comprehensive clinical evaluation, laboratory investigations, and transthoracic echocardiography were performed. Echocardiographic parameters, including left ventricular ejection fraction (LVEF), diastolic function, and left ventricular hypertrophy, were assessed according to the recommendations of the American Society of Echocardiography. Associations between LV dysfunction and demographic, clinical, and biochemical variables were evaluated using appropriate statistical methods. Results: The analysis demonstrated that diastolic dysfunction (61.5%) was more common than systolic dysfunction (31.7%), while left ventricular hypertrophy was observed in over half of the study population. The prevalence of LV dysfunction increased significantly with advancing CKD stage. Advanced CKD, hypertension, anaemia, diabetes mellitus, and maintenance haemodialysis were identified as significant predictors of LV dysfunction. Conclusion: This study illustrates the substantial burden of cardiac dysfunction among patients with CKD and highlights the progressive increase in LV dysfunction with worsening renal disease. Routine echocardiographic evaluation may facilitate early identification of cardiac abnormalities and support timely cardiovascular risk management.