DISSERTATION TOPIC

THESIS TITLE:
THERAPEUTIC OUTCOMES IN PATIENTS WITH CARDIOVASCULAR DISEASE IN CHRONIC KIDNEY DISEASE.

PROBLEM STATEMENT: 
CKD is common in patients with heart failure, associated with high mortality and morbidity, which is even higher in people undergoing long-term dialysis. Despite increasing use of evidence-based drug and device therapy in patients with heart failure in the general population, patients with CKD have not benefitted

AIM:
MANAGING CARDIOVASCULAR DISEASE IN PATIENTS WITH CHRONIC KIDNEY DISEASE.

OBJECTIVES: 
1. To study the cardiac changes and complications in patients with chronic kidney disease.
2. To improve outcomes in patients having heart failure with CKD.
3. Understanding development LV dysfunction.


PATIENTS AND METHODS:
PLACE OF STUDY: Kamineni Institute of Medical Sciences and Hospital, Narketpally. 
 STUDY PERIOD: November 2022 to October 2024.
STUDY DESIGN: Prospective study.
SAMPLE SIZE : 60.

INCLUSION CRITERIA:
The following criteria were used in the selection of cases: Patients-
1. Who were known chronic kidney disease Patients.
2. Who were symptomatic for 3 months and more.
3. Serum creatinine more than 3 mg%.
4. Patients with bilateral contracted kidneys on USG Abdomen with poor corticomedullary differentitation and type 2 or 3 renal parenchymal changes. 


EXCLUSION CRITERIA:
1. Patients who were known valvular heart disease, coronary artery disease.
2. Patients below 18 years of age.
3. Patients not capable of giving consent (mentally ill patients). 
 4. Patients not willing to participate in the study. And lost to follow-up.

PROFORMA: 
IP NO: 
NAME: 
AGE:
SEX:

PRESENTING SYMPTOMS:
 

PAST HISTORY:


EXAMINATION:
 Pallor JVP
 Pedal edema
 CVS: RS:
 Abdomen: 
CNS:
 PR:
 RR:
 BP: 
 TEMP:
 BODY WEIGHT:
 Mean BP:
INVESTIGATIONS:
1) Complete hemogram:
2) Urea:
3) Sr. Creatinine:
4) eGFR:
5) Blood sugar:
6) Urine:
7) Sr. proteins:
8) Sr. uric acid: 
9) Liver function tests:
10) Sr. calcium:
11) Sr. Phosphorus: 
12) Sr. Electrolytes:
13) USG abdomen:
14) ECHOCARDIOGRAPHY:
 CHAMBERS:
 SYSTOLIC FUNCTION:
 DIASTOLIC FUNCTION:
 PERICARDIUM:
 VALVES:
 FINAL IMPRESSION OF ECHOCARDIOGRAPHY:


PATIENT INFORMATION SHEET

English:

https://drive.google.com/file/d/12LLDgFBVfnTxDdNIv5K715uSyLYPUEgrY/view?usp=drivesdk

Telugu:

https://drive.google.com/file/d/13Df9wCu9zhjECpPxcHEULSAphv6-tDHl/view?usp=drivesdk


THESIS CASES:


31. http://drkranthimenmula.blogspot.com/2024/07/code-cl.html

• Segall L, Nistor I, Covic A. Heart failure in patients with chronic kidney disease: a systematic integrative review. Biomed Res Int. 2014;2014:937398. doi: 10.1155/2014/937398. Epub 2014 May 15. PMID: 24959595; PMCID: PMC4052068.


• Charles A. Herzog, Richard W. Asinger, Alan K. Berger, David M. Charytan, Javier Díez, Robert G. Hart, Kai-Uwe Eckardt, Bertram L. Kasiske, Peter A. McCullough, Rod S. Passman, Stephanie S. DeLoach, Patrick H. Pun, Eberhard Ritz,
Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO),Kidney International,
Volume 80, Issue 6,2011,Pages 572-586,ISSN 0085-2538,
https://doi.org/10.1038/ki.2011.223.
(https://www.sciencedirect.com/science/article/pii/S0085253815551053)

• Banerjee D, Rosano G, Herzog CA. Management of Heart Failure Patient with CKD. Clin J Am Soc Nephrol. 2021 Jul;16(7):1131-1139. doi: 10.2215/CJN.14180920. Epub 2021 Jan 25. PMID: 33495289; PMCID: PMC8425606.

• Tuegel C, Bansal N. Heart failure in patients with kidney disease. Heart. 2017 Dec;103(23):1848-1853. doi: 10.1136/heartjnl-2016-310794. Epub 2017 Jul 17. PMID: 28716974.

• Banerjee D, Wang AY. Personalising heart failure management in CKD patients. Nephrol Dial Transplant. 2021 Feb 16:gfab026. doi: 10.1093/ndt/gfab026. Epub ahead of print. PMID: 33591313.

• Nguyen M, Rumjaun S, Lowe-Jones R, Ster IC, Rosano G, Anderson L, Banerjee D. Management and outcomes of heart failure patients with CKD: experience from an inter-disciplinary clinic. ESC Heart Fail. 2020 Oct;7(5):3225-3230. doi: 10.1002/ehf2.12796. Epub 2020 Jul 11. PMID: 32652822; PMCID: PMC7524254.

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