ANAEMIA IN CHRONIC KIDNEY DISEASE IN LASUTH: IMPACT ON QUALITY OF LIFE AND LEFT VENTRICULAR MASS INDEX
Anaemia is a common complication of chronic kidney disease(CKD), and has been shown to
worsen as CKD advances. It has also been identified as an independent predictor of left
ventricular hypertrophy (LVH) among CKD patients, and worsens their cardiovascular outcome,
and impacts negatively on their quality of life.
The aim of this study was to assess the prevalence and geometric pattern of LVH among anaemic
CKD patients, and the relationship between the severity of anaemia and its impact on the quality
of life of anaemic CKD patients attending nephrology clinic at Lagos State University Teaching
Methods: A cross sectional analytical study was carried out within a 10 month period (April
2016 to January 2017). A total of one hundred and sixty three subjects were recruited which
included one hundred and two anaemic CKD subjects and sixty one CKD subjects without
anaemia as controls. Karnofsky structured questionnaire was used to assess quality of life,
echocardiogram was used to determine the presence of LVH, the left ventricular geometric
pattern (L.V geometry) and the left ventricular systolic function, while the packed cell volume
was used to categories subjects into severity of anaemia.
Result: The mean age of anaemic CKD subjects was 54.04 ± 14.47 years, while those of controls
was 54.92 ± 15.67 years, with t = -0.364, p = 0.717. The duration of CKD among anaemic CKD
subjects was 3.41 ± 5.22 years and controls was 3.09 ± 2.57 years, with t = 0.442 and P = 0.659.
The prevalence of anaemia among CKD subjects was 102(62.6%), and it significantly worsens
as CKD advances, which ranged from 42.3% in stage 3 to 93% in stage 5 (X2 = 29.69, p <
0.001). The mean physical performance score was significantly lower among anaemic CKD
subjects than controls, which was 73.17 ± 12.95 and 84.59 ± 11.04 respectively, with t = -5.739
and P < 0.001. Furthermore, the mean physical performance score decreases significantly with
advancing CKD among both study groups. The prevalence of LVH among anaemic CKD
subjects was 64(68.8%), and was not significantly different among CKD subjects without
anaemia was 33(57.9%), X2 = 1.845, p = 0.174, O.R = 1.61, and 95% C.I was 0.81 – 3.17. The
most frequent pattern of LVH seen among both groups was concentric LVH which was 50
(53.8%), and 25(43.9%) among both anaemic CKD subjects and controls respectively, X2 =
2.385, and p = 0.497. The overall prevalence of left ventricular systolic dysfunction among
subjects was 68(45%), with significantly higher frequency among anaemic CKD subjects
58(61.7%), than controls 10(17.5%), with X2 = 27.952 and p < 0.001, O.R = 7.57, and 95% C.I =
3.43 – 16.73. Also there was a strong negative correlation between packed cell volume and left
ventricular mass index with correlation coefficient (r = -0.345, p = 0.001) among anaemic CKD
subjects, but weak positive correlation among controls (r = 0.001, p = 0.993).
Conclusion: This study showed that CKD patients with anaemia had significant impairment in
their physical ability than CKD patients without anaemia, and high prevalence of LVH and poor
left ventricular systolic function among them.