Summary
Cardiovascular disease in patients with stage IV and V of chronic kidney disease

Introduction. The cardiovascular disease (CVD) is the first cause of death in patients with stage IV and V of chronic kidney disease (CKD).
Objective. To identify the CVD in patients with stage IV and V of CKD.
Method. Through a systematic selection, 84 patients (48 stage IV CKD and 36 stage V CKD) were include in a cross-sectional study from April 2013 to April 2014 in the Nephrological Centre of Lucía Íñiguez Hospital, Holguín, Cuba. Clinical examination, electrocardiogram, 2D and Doppler echocardiogram were made to them. Age, ventricular function, type of CVD and number of CVD associated were study. Chi-square test was used as statistical analysis.
Results. The ages of 41-50 years (33%) and over 60 years (33%) predominated in patients with stage IV CKD and the ages of 41-50 years (44.4%, p=0.30) in stage V CKD. The 91% of patients with stage IV CKD and the 100% with stage V CKD (p=0.20) had diastolic dysfunction (DD). In patients with stage IV CKD, hypertrophic cardiomyopathy (HMCP) was identified in 50%, coronary artery disease (CAD) in 25% and uremic cardiomyopathy (UMCP) also in 25%; in patients with stage V CKD, the HMCP was 88% (p=0.008), CAD 66% (p=0.007), valvular heart disease (VHD) 55% (p=0.000) and pericarditis 33% (p=0.20). The 41% of patients with stage IV CKD had two ECV and 77.7% of patients with stage V CKD had more than three ECV (p=0.01).
Conclusion. All patients with stage V CKD had CVD with DD, most with more than three CVD; HCMP, CAD and VHD were the principal CVD; while HCMP, CAD and UCMP were the principal CVD in patients with stage IV CKD.

Keywords: Cardiovascular disease ; Chronic kidney disease ; Ventricular dysfunction ; Hemodialysis ; Uremic cardiomyopathy ; Coronary artery disease in hemodialysis