title: Pattern and presentation of cardiac diseases among patients with chronic kidney disease attending a national referral hospital in Uganda: a cross sectional study.
abstract: BACKGROUND
  Chronic kidney disease is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the primary cause of morbidity and mortality in patients with chronic kidney disease. There is limited data on cardiovascular diseases among chronic kidney disease patients in resource limited settings including Uganda. We determined the prevalence and patterns of cardiac diseases among patients with chronic kidney disease attending the nephrology outpatient clinic in Mulago National Referral Hospital in Uganda.
  
  
  METHODS
  This was a cross sectional study in which two hundred seventeen patients with chronic kidney disease were recruited over a period of 9 months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting electrocardiography and transthoracic echocardiography performed for all study participants and findings entered into a data sheet.
  
  
  RESULTS
  One hundred eleven (51.2 %) of the 217 participants were male. Mean age was 42.8 years. One hundred eighteen (54.4 %) of patients had either eccentric or concentric left ventricular hypertrophy. Patients with left ventricular hypertrophy were more likely to be hypertensive (p < 0.001) or anemic (p = 0.034). Up to 9.2 % of study subjects had valvular heart disease (rheumatic or degenerative) and 22 % had pericarditis. Forty one patients (18.9 %) had left ventricular systolic failure (Ejection fraction < 50 %). There was a higher prevalence of systolic failure in patients with left ventricular hypertrophy (21 % vs. 16 %) although this was not statistically significant, p = 0.346. Thirty eight participants (17.5 %) had diastolic failure while 2 % had cardiac rhythm abnormalities.
  
  
  CONCLUSIONS
  Cardiac abnormalities are common in a predominantly young African population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.
authors.affiliation: Department of Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda. b2kriss@gmail.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Babua
authors.affiliation: Nephrology Division, Department of Medicine, Makerere University, College of Health Sciences, Kampala, Uganda. rkalyes@yahoo.com.
authors.forename: Robert
authors.initials: R
authors.lastname: Kalyesubula
authors.affiliation: Uganda Heart Institute, Kampala, Uganda. emmkol@hotmail.com.
authors.forename: Emmy
authors.initials: E
authors.lastname: Okello
authors.affiliation: Uganda Heart Institute, Kampala, Uganda. barbarakakande@yahoo.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kakande
authors.affiliation: Uganda Heart Institute, Kampala, Uganda. esebatta@gmail.com.
authors.forename: Erias
authors.initials: E
authors.lastname: Sebatta
authors.affiliation: Cardiology Division, Department of Medicine, Mulago National Referral Hospital, Kampala, Uganda. mmungos@yahoo.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Mungoma
authors.affiliation: Cardiology Division, Department of Medicine, Mulago National Referral Hospital, Kampala, Uganda. charlesmondo2011@gmail.com.
authors.forename: Charles
authors.initials: C
authors.lastname: Mondo
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000453:epidemiology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D013318:Stroke Volume; D014454:Uganda / Q000453:epidemiology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology