Cardiac Function in an African Dialysis Population with a Low Prevalence of Pre-Existing Cardiovascular Disease

Cardiac dysfunction is highly prevalent in dialysis patients in the developed world, and is a major cause of morbidity and mortality. The relative impact of pre-existing cardiac disease and dialysis/uremia on cardiovascular morbidity are not clear. We conducted a retrospective, cross-sectional analysis of cardiac function and mortality in 202 incident and prevalent dialysis patients over an 18-month period in a population with a low prevalence of cardiovascular disease at dialysis initiation. Systolic dysfunction was defined as an ejection fraction (EF) of <50%. Left ventricular hypertrophy (LVH) was determined by echocardiography or electrocardiogram. Clinical data was collected by chart review. Ninety-nine percent of patients were black, with a mean age of 41.7 ± 10.1 years, and median follow up 28 months (range 1–216 months). Echocardiograms were available in 132 patients. Seventy-seven patients received hemodialysis, and 55 received peritoneal dialysis. Mean EF was 63.2 ± 11.1. EF was not lower in pat...