European Journal of Molecular & Clinical Medicine

Background
Chronic Kidney Disease (CKD) is recognized as a major medical problem
worldwide. Electrocardiogram (ECG) remains an essential tool despite the development of
modern technologies, for evaluation of cardiovascular disease.
Aim
To study the electrocardiographic findings along with the associations with the laboratory
variables and prevalence of cardiac arrhythmias in patients of chronic kidney disease
undergoing haemodialysis.
Method
The study was conducted on 100 in-patients who were undergoing Haemodialysis in G.R.
Medical College, Gwalior. A standard 12 lead ECG was obtained just before and after the
haemodialysis procedure. The electrocardiograms was reviewed on descriptive reports of
variables: Rhythm, Heart rate , P wave abnormalities, LVH, QT interval/ QTc, ST segment
changes. Patient was placed on the Holter monitor for 24 hours just an hour before the
dialysis.
Result
In the study subjects , there were 51% of them who had serum creatinine of (5.1-10mg/dL)
and 2% had serum creatinine of ( > 20 mg/dL). There were 37% of the study subjects who
were Smoking and 27% of them were Alcoholics, 81% were Hypertensives , 19% were
having Diabetes Mellitus and 14 % were Obese. It was observed that 5% of the subjects
showed Atrial Fibrillation on ECG after Dialysis and 95% of them showed a Sinus
Rhythm. Changes in the ST segment and Tall T wave on ECG were observed in 25% and
35% of the study subjects. Supraventricular Ectopic findings were observed in 19% before
dialysis and 48% during dialysis and 15% after dialysis respectively. On ECHO, 60% of
subjects showed Left Ventricle Hypertrophy and 28% had Diastolic dysfunction.

Background: Renalase is a blood-secreted protein produced only by the kidney; its
blood level approximately 3–5 μg/ml. The Left ventricular hypertrophy (LVH) is
defined by an augmented left ventricular mass that may be measured via
echocardiography or magnetic resonance imaging (MRI). The aim of the present
study was to study whether Renalase is a marker or has a potential role in
developing myocardial hypertrophy in CKD patients under hemodialysis (HD)
treatment.
Patients and methods: To achieve this target, 90 patients on maintenance HD were
incorporated in the present study.
Results: The mean renalase levels were 61.7±67.5 ng/mL in HD patients. The cutoff
value of Renalase was >57.9 ng/ml with a sensitivity of 92.3% and a Specificity of
84.0%. The mean LVMI of the studied dialysis patients was 138 g/m2. The majority
of cases were severely abnormal (60%). There was a statistically significant
difference between the age groups and the LVMI among dialysis patients. The level
of Renalase was significantly increased with the moderately and severely abnormal
LVMI among dialysis patients. The present study disclosed statistically significant
relations between the duration of dialysis and Renalase, HDL, CRP, and LVMI.
There were significant relations between the serum renalase and s. creat, bl. Urea,
Ph, LVMI and dialysis vintage. Also, there were significant positive relations
between LVMI and Hb, CRP, and dialysis vintage.
Conclusion: Renalase could be a novel predictive biomarker in the assessment of
LVH, which is closely associated with the increased risk of death in HD patients.

 
Background: Hypertension is a growing concern in the Indian population with urbanization and developments in work culture and treatment methods.
Aim and objective: To evaluate the influence of serum magnesium levels in gradations of primary hypertension and evaluate its impact on co-morbid conditions.
Methods: Hypertensive patients were screened and included in the study by categorizing them in to grade I and II based on blood pressure levels. Socio-demographic, physical and systemic examination details were recorded with pre-designed questionnaire; electrolyte levels, fasting blood sugar, status of retina and heart were assessed and analyzed using t-test and logistic regression.
Results:Total 100 patients in the study, mean age was 59.3±14.79 years; male predominance (61%); normal retina (83%) and presence of pre-diabetic conditions (67%) was observed, with normal serum magnesium levels in majority (76%). Serum magnesium levels were significantly associated with grade I (P = 0.0173) patients; influencing systolic and diastolic blood pressure values (r = -0.3552, P = 0.003; r = -0.2160, P = 0.0309, respectively).
Conclusion:The optimal values can be further established by evaluation of large sample size, quality of life during treatment, and influence of co-morbidities/complications of hypertension, among others.