title: Pattern and correlates of cardiac lesions in a group of sub-Saharan African patients on maintenance hemodialysis.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of morbidity and mortality in patients on maintenance hemodialysis. We investigated the pattern and correlates of cardiac lesions in a group of Cameroonians on chronic hemodialysis.
  
  
  METHODS
  This was a cross-sectional study conducted at the Yaoundé General Hospital's hemodialysis unit, involving 45 patients (29 men, 64%) on maintenance hemodialysis for at least three months using a native arterio-venous fistula. Cardiovascular risk factors, biological, electrocardiographic and echocardiographic data were collected.
  
  
  RESULTS
  Hypertension (29%), chronic glomerulonephritis (24%) and diabetes mellitus (24%) were the main etiological factors of chronic kidney disease. Blood pressure was controlled in 14 (31%) patients. Nineteen (42%) patients had anemia and 5 (14%) had a calcium-phosphorus product >55 mg(2)/dl(2). All patients had at least one cardiovascular risk factors with hypertension (95%), anemia (42%) and highcalcium-phosphorus product (42%) being the most frequent. Thirty-eight (84%) patients had at least one cardiac lesion and 11 (29%) had three or more lesions. The cardiac lesions were left ventricular hypertrophy (60%), valvular calcifications (38%), heart failure (36%), conduction disorders (33%), pericardial effusion (13%), valvular diseases (11%) and ischemic heart diseases (2%). Left ventricular hypertrophy was significantly associated with a longer duration on dialysis and low hemoglobin level (both p < 0.047) while cardiac failure and valvular calcifications were associated with advanced age and high interdialytic weight gain (both p <0.05).
  
  
  CONCLUSIONS
  Cardiac lesions and cardiovascular risk factors are frequent in these patients receiving sub-optimal dose maintenance hemodialysis despite their younger age, suggesting an increased susceptibility to cardiovascular complications.
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences &Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Francois Folefack
authors.initials: FF
authors.lastname: Kaze
authors.affiliation: South African Medical Research Council & University of Cape Town, Cape Town, South Africa.
authors.forename: Andre-Pascal
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences &Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Al Mamy Aboubakar
authors.initials: AM
authors.lastname: Djalloh
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences &Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Gloria
authors.initials: G
authors.lastname: Ashuntantang
authors.affiliation: Department of Internal Medicine, Faculty of Medicine and Pharmaceutical Sciences & Douala General Hospital, University of Douala, Douala, Cameroon.
authors.forename: Marie Patrice
authors.initials: MP
authors.lastname: Halle
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences &Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Alain Patrick
authors.initials: AP
authors.lastname: Menanga
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences &Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kingue
mesh_terms: D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012307:Risk Factors
keywords: Cameroon; Cardiac lesions; Sub-Saharan Africa; chronic hemodialysis