European Journal of Cardiovascular Medicine

Background: Left atrial enlargement (LAE) has been proven to be significantly related to stroke and cardiovascular diseases. Previous studies have shown a link between Left atrial enlargement (LAE) with the increase in the risk of stroke and cardiovascular diseases (CVD). Bangladeshi data is lacking on the exact prevalence of LAE. Aims and Objectives: To study the prevalence of LAE and its associated risk factors. Materials and Methods: Hundred patients having were studied in the Department of Vascular Surgery, Bangabandu Sheikh Mujib Medical University (BSMMU), and Dhaka, Bangladesh from January 2020 to December 2020. After a complete physical examination, echocardiogram was performed in all the patients. In present study LAE is defined if the LA diameter is more than 4.0 cm in men and 3.8 cm in women. We performed multivariable logistic regression analysis to identify risk factors for LAE. Results: Prevalence of LAE was 8%. The prevalence of LAE was higher in men (9.37%). On multivariable logistic regression analysis advancing age (OD;1.034), increased systolic blood pressure (SBP) (OR: 2.862), increased diastolic blood pressure (DBP) (OR: 1.32), abnormally high BMI (OR: 3.721), increased prevalence of diabetes (OR: 1.245), increased left ventricular myocardial index (LVMI) (OR: 1.023), and decreased left ventricular ejection fraction (LVEF), decreased heart rate (HR), and decreased estimated glomerular filtration rate (eGFR) were found to be the major risk factors of LAE. Conclusion: A significant number of patients had LAE. Among the risk factors advancing age, increased SBP, increased BMI, presence of diabetes mellitus, increased LVMI, decreased eGFR, decreased LVEF, and decreased HR were more common.

Background: The danger of chronic kidney disease (CKD) is rising quickly worldwide and has become a main health crisis and most of these patients die from cardiovascular disease (CVD) prior to progression to end stage renal disease (ESRD), therefore, Poor cardiovascular outcomes in CKD patients have encouraged nephrologists to search for biomarkers that may improve risk stratification in this population. The aim of this study was to assess serum brain natriuretic peptide (BNP) hormone and cardiac troponin T (cTnT) levels in CKD patients and to determine their involvement with cardiovascular diseases. Methods: This analytical case control study was conducted at Ibn sina and Military hospitals in the period from February 2016 to March 2019, (n = 150) clinically diagnosed CKD patients (age range between 22 - 76 years, 105 males and 45 females), and (n = 150) healthy subjects were included as controls. Serum BNP hormone and cardiac troponin T (cTnT), were estimated by Cobas E-411® fully automated analyzer, serum creatinine by Cobas C-311® fully automated analyzer, hemoglobin by Sysmix, glomerular filtration rate (GFR) was calculated by Cocroft-Gault formula and blood pressure was measured by using mercuric sphygmomanometer. Results: Serum BNP, cTnT, creatinine, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) were significantly higher in CKD patients than in controls, while hemoglobin and GFR were significantly lower. Moreover, serum BNP, cTnT, SBP and DBP were significantly higher in CKD patients with cardiovascular disease (CVD) than CKD patients without CVD. In addition, serum BNP, at cutoff level of 240 pg/ml, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 87%, 90%, 52% and 92%, respectively in relation to CVD, while serum cTnT, at cutoff level of 0.1 ng/ml, the sensitivity, specificity, PPV and NPV were 80%, 57%, 46% and 74%, respectively. Furthermore, there was an association between elevated BNP levels and CVD outcomes in patients with CKD, since it is a strong risk factor for CVD (OR: 1.48, p. value 0.031). Conclusions: BNP levels are significantly associated with cardiovascular events (left ventricular hypertrophy and systolic dysfunction) in patients who have CKD and are on maintenance hemodialysis (HD)

Background- Given the strong correlation between cardiac disease and chronic kidney disease (CKD), it is possible that even a slight drop in glomerular filtration rate (GFR) can act as a risk factor for developing cardiovascular abnormalities. Cardiovascular disease (CVD) patients with CKD had mortality risks that were three to thirty times higher than those of the general population. Methods- This cross-sectional study was conducted in the Medicine unit of Postgraduate Medical Center of Central India within 6 months duration. The analysis included a total of 140 patients who had been receiving maintenance for more than a year. Two-dimensional transthoracic echocardiography was done in each patient for the determination of cardiac structural and functional parameters such as LV hypertrophy, LV systolic dysfunction, and LV diastolic dysfunction. Results- Out of 140 patients, there were 75.7% males and 24.3% females. Maximum number of patients belonged to age group of 51-60 years. Mean age of ESRD patients was 53.3 ± 12.8. Hypertension (37.1%) was leading cause of ESRD, other causes included diabetes (21.4), diabetes with hypertension (10%), chronic glomerulonephritis (8.6%), polycystic kidney disease (7.1%), obstructive uropathy (5.7%), analgesic nephropathy (2.9%) and aetiology remained unknown in 7.1% cases. Conclusion- Left ventricular dysfunction was most common in ESRD patients. LVH was the most common ESRD echocardiographic abnormality. More ESRD patients had diastolic dysfunction than systolic dysfunction. Left ventricular hypertrophy and diastolic dysfunction were mostly caused by anaemia and hypertension. Systolic dysfunction was caused by ischaemic heart disease-related RWMA. Echocardiography detected LVH and minimal pericardial effusion before clinical diagnosis

Background:  Hypertension in pregnancy is a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or both. Both systolic and diastolic blood pressure raises are important in the identification of Pregnancy induced hypertension. Pregnancy induced hypertension (PIH) is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. The broad classification of pregnancy-induced hypertension during pregnancy is gestational hypertension (GE), pre-eclampsia and eclampsia. Serum uric acid and creatinine levels are a part of work up for the pregnant women with hypertension. The elevated levels of these parameters were due to decreased urinary clearance secondary to reduced Glomerular filtration Rate (GFR) and increased reabsorption. Materials and methods: The present study was carried out in the Department of Biochemistry, Dr VRK Womens Medical College, Teaching hospital and Research center. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders – such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease – were excluded from the study. Results:  In our study, we observed a significantly elevated serum uric acid PIH (9.51 ± 1.33 mg/dl) and Normal pregnant women (5.29 ±0.8 mg/dl). Blood Urea was 5.29 ±0.8 mg/dl among Normal pregnant women and 9.51 ±1.33 mg/dl among PIH. Moreover, Serum Creatinine level was1.25±0.53 mg/dl among PIH and 0.97±0.23 mg/dl among Normal pregnant women. Conclusion: On the basis of study findings we, concluded that the increased levels of serum uric acid, serum creatinine and serum urea are better diagnostic and predictive marker for PIH and immediate medical attention required for PIH. With the help of these parameters most cases are detected early in the pregnancy before they can progress to eclampsia

Aim :To Evaluate the Diagnostic Efficiency of Cystatin C As a marker of Early Renal injury in patients of Type 2 Diabetic in comparison with Creatinine. Materials and Methods : 100 proven cases of type 2 Diabetes categorized into 3 groups. Normoalbuminuria (48), microalbuminuria (32) & macroalbuminuria (20). 50 age and sex matched healthy controls. Fasting plasma glucose(FPG), serum Creatinine, serum Cystatin C, urine dipstick analysis for protein, urine albumin, urine creatinine & calculated UACR were estimated. Glomerular filtration rate was estimated by Cystatin C concentrations according to Chronic Kidney Disease Epidemiology (CKD-EPI) equation and Creatinine eGFR according to Modification of Diet in Renal Disease (MDRD). Results : There was raised levels of FPG , serum Creatinine & serum Cystatin C significantly (p<0.01) with increasing duration of Diabetes. The eGFR of Cystatin C was lower than that of Creatinine eGFR in cases but in controls it was more. The calculated sensitivity of Cystatin C eGFR was 91%,specificity was 94% and overall accuracy(OA) was 92% and these results are better than that of Creatinine eGFR with 84% sensitivity ,88% specificity and 85% OA. The eGFR cystatin c showed higher sensitivity, high specificity & higher accuracy than eGFR creatinine in studied diabetic subjects. Cystatin C showed more significant correlation with Cys C e GFR, (r = −0.99, p<0.001) than serum creatinine e GFR ( r= −0.86,p<0.001) in diabetic patients. Conclusion:The results of present study showed Cystatin C was more sensitive than creatinine thereby making se Cystatin.

Introduction: Renal function is evidently modified in both hypothyroidism and hyperthyroidism. However, there is a scarcity of clinical data on the relationship between thyroid disease and renal function. The objective of this study was to evaluate alterations in biochemical indicators of renal function in individuals with thyroid dysfunction and to correlate these measurements with the patient's thyroid hormones. Material and Methods: A total of 25 patients with primary hyperthyroidism and 294 patients with primary hypothyroidism were included as cases. A group of 100 persons who were in good health were selected as controls. Immunoassay was used to evaluate thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). The serum levels of urea, creatinine, and uric acid were measured using an EM-360 autoanalyzer. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) algorithm. Renal function tests were evaluated in all cases. Results: The results of our study showed a significant increase in the average levels of serum urea (36.26±3.69) and uric acid (6.55± 0.34) in patients with hypothyroidism. This increase was statistically significant (p value < 0.001). Similarly, we observed a significant increase (p value < 0.001) in serum urea (29.98±2.17) and uric acid (6.59± 0.34) levels in patients with hyperthyroidism. Nevertheless, hyperthyroid patients exhibited a decrease in serum creatinine levels (0.70± 0.04) compared to the control group, resulting in an increase in estimated glomerular filtration rate (eGFR) (121.55± 5.79). Conversely, the hypothyroid group showed a significant increase in creatinine levels (1.04± 0.05) (p value < 0.001), leading to a decrease in eGFR (102.05± 5.38) compared to the control group. Conclusion: Thyroid dysfunction is linked to abnormal renal function. The clinician should recognize the association between thyroid problems and abnormal kidney function to consider performing a thyroid function test for patients with slightly raised biochemical indicators of renal function during treatment. Monitoring creatinine levels is necessary for people with thyroid disease.

Chronic kidney disease (CKD) is a growing health concern in India, especially due to the increased prevalence of chronic diseases such as diabetes mellitus and hypertension (Mk, 1993). This study evaluates the prognostic significance of key biomarkers in CKD patients, including 24-hour urinary protein, estimated glomerular filtration rate (eGFR), and serum uric acid levels, alongside renal pathology and immunofluorescence findings. By assessing the relationships between these indicators, the research aims to enhance prognostic accuracy, predict CKD progression, and improve patient outcomes in the Indian context. The findings emphasize the importance of a comprehensive evaluation of these prognostic indicators in managing CKD effectively. Introduction: Chronic kidney disease (CKD) affects a substantial portion of the population in Indian subcontinent as well as globally, leading to adverse outcomes if not managed effectively. This paper aims to assess the utility of 24-hour urinary protein, eGFR, uric acid levels, renal pathology, and direct immunofluorescence findings as prognostic indicators in CKD. By exploring the relationships between these markers and disease progression, the study seeks to provide insights for personalized treatment strategies and improved patient care. Materials and Methods: This study was conducted as a retrospective, observational cohort study. Data has been collected from medical records of 50 CKD patients attending the nephrology OPD at MGM Medical college and Hospital, Kamothe, Navi Mumbai from the period of January 2022 to July 2023. Results: The study revealed significant correlations between 24-hour urinary protein, eGFR, uric acid levels, and specific renal pathologies. Higher levels of urinary protein and lower eGFR were robust predictors of CKD progression, while serum uric acid levels showed potential as a marker of disease severity. The findings underscored the importance of a comprehensive evaluation of prognostic indicators in CKD management. Conclusion: In conclusion, this research paper underscores the value of incorporating diverse prognostic indicators in CKD management to enhance diagnostic accuracy and treatment planning. By analyzing the interplay between traditional markers, renal pathology, and immunofluorescence findings, clinicians can refine prognostic models, predict CKD progression, and optimize patient outcomes. The study's insights offer valuable guidance for personalized care and improved prognostication in CKD patients.

This community-based observational study explored the relationship between circulating free triiodothyronine (FT3) levels and the progression of diabetic nephropathy in patients with Type 2 diabetes mellitus over one year. A total of 482 participants from Mayurbhanj, Odisha were stratified into quartiles based on their FT3 levels. The results indicated that those in the lowest FT3 quartile exhibited significantly greater progression of nephropathy, as evidenced by declines in estimated Glomerular Filtration Rate (eGFR) and increases in urine albumin to creatinine ratio (ACR), compared to those in higher quartiles. These findings suggest that FT3 could serve as a valuable prognostic marker for diabetic nephropathy progression, emphasizing the need for further research into thyroid function management as a component of diabetes care

Background- chronic kidney disease (CKD) is a public health problem worldwide with a global prevalence of 11 to 13%¹. It is a pathophysiological process with multiple etiologies, resulting in inexorable attrition of nephron number and function leading to end stage renal disease. Cardiovascular diseases (CVD) are becoming the major cause of morbidity and mortality in most of the developing countries; including India in patients of chronic kidney disease³. Aim- To assess left ventricular functional status on echocardiography in chronic kidney disease patients. Methods and materials- This is a Observational Cross-sectional study, done in cases of chronic kidney disease admitted under medicine department & those attending the medical OPD of Deen Dayal Upadhyay Hospital, New Delhi, for a period of 2 years from November 2017 to November 2019. CKD patients were selected on basis of selection criteria as mentioned above. All patients were be clinically evaluated thoroughly. After taking informed consent, these individuals were subjected to the following investigations. GFR Estimation was be done using Modification of Diet in Renal Disease (MDRD) equation and staging of CKD was done on the basis of estimated GFR as per KDIGO guidelines. Categorical variables were presented in number and percentage (%) and continuous variables were presented as mean ± SD and median. The data was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results- Majority of the patients included were in stage 3 (44%) followed by stage 4 (35%) CKD. The mean blood urea was 89.14 ± 24.28 mg/dl, mean serum creatinine was 3.14±1.46mg/dl, mean eGFR was 26.96± 13.31, mean LVEF was 49.92± 9.23 & mean e/a ratio was 1.13 ± 0.53. Systolic dysfunction was present in 24% of CKD patients. Systolic dysfunction was present in 6% of mild/moderate CKD patients & in 42% of severe CKD patients. The association of systolic dysfunction between these two groups was statistically significant (p = <0.0001). In the mild/moderate CKD group out of 50 patients only 3 had systolic dysfunction & it was of the mild variety in all three of them. In the severe CKD group out of 50 Patients, 21 had systolic dysfunction of which maximum patients had moderate systolic dysfunction (41.67%) followed by mild and severe systolic dysfunction in 29.17% patients each. The association of severity of systolic dysfunction between these two groups was statistically significant. Diastolic dysfunction was present in 58% CKD patients, 46% of mild/moderate CKD patients & in 70% of severe CKD patients. The association of diastolic dysfunction between these two groups was statistically significant (p = 0.026). In this study E/A ratio < 0.8 was seen in 34% of mild/moderate CKD group patients & in 24% of severe CKD group patients and the association between these two groups was statistically not significant. E/A ratio of 0.8-2 with an E/e’ ratio >10 was seen in 30% of severe CKD group patients & in 10% of mild/moderate CKD group patients and the association between these two groups was statistically significant. E/A ratio > 2 was seen in 16% of severe CKD group patients & in 2% of mild/moderate CKD group patients and the association between these two groups was statistically significant. Conclusion- Echocardiography is a cost effective, noninvasive and easily reproducible diagnostic test which can detect early changes in the cardiac parameters. This is important for risk stratification and early preventive measures. Thus, echocardiographic screening of CKD patients has both therapeutic and prognostic implications. All asymptomatic CKD patients should undergo a routine echocardiographic evaluation.

Background: Postoperative acute kidney injury (AKI) remains a significant complication in high-risk surgical patients, contributing to increased morbidity, prolonged hospital stays, and higher mortality rates. Fluid management during the perioperative period plays a critical role in maintaining renal perfusion and preventing ischemic kidney injury. Goal-Directed Fluid Therapy (GDFT), an individualized approach using hemodynamic monitoring to optimize fluid administration, has been proposed as a strategy to improve renal perfusion and organ function in surgical patients. However, its impact on postoperative renal function, particularly in high-risk populations, remains a subject of ongoing investigation. This study aims to evaluate the effectiveness of perioperative GDFT in preserving renal function and reducing the incidence of postoperative AKI in high-risk surgical patients. Objective: To assess the impact of perioperative Goal-Directed Fluid Therapy (GDFT) on postoperative renal function, determine its role in reducing AKI incidence, and compare it with standard fluid management protocols in high-risk surgical patients. Methods: This prospective observational study was conducted over six months in the surgical and critical care units of a tertiary care hospital, enrolling 50 high-risk surgical patients undergoing major non-cardiac surgery. Patients were divided into two groups based on intraoperative fluid management strategy: •GDFT Group: Patients managed using non-invasive hemodynamic monitoring (stroke volume variation, cardiac output, dynamic fluid responsiveness) to guide fluid administration. •Standard Fluid Therapy (SFT) Group: Patients managed using a fixed, weight-based fluid administration approach. Preoperative renal function was assessed using serum creatinine, estimated glomerular filtration rate (eGFR), and urine output. Postoperative renal function was evaluated using Acute Kidney Injury Network (AKIN) criteria, comparing serum creatinine changes, urine output, and AKI incidence between the two groups at 24 hours and 72 hours postoperatively. Secondary outcomes included length of hospital stay, need for renal replacement therapy (RRT), and overall morbidity and mortality rates. Results: The incidence of postoperative AKI was significantly lower in the GDFT group (12%) compared to the SFT group (32%) (p < 0.05). Patients in the GDFT group maintained better renal function, as indicated by lower serum creatinine elevation (mean increase of 0.2 ± 0.1 mg/dL vs. 0.5 ± 0.2 mg/dL in SFT, p < 0.05) and higher urine output (mean 1.2 ± 0.4 mL/kg/hr vs. 0.7 ± 0.3 mL/kg/hr, p < 0.05). The requirement for renal replacement therapy (RRT) was lower in the GDFT group (4%) compared to the SFT group (12%), although this difference was not statistically significant. Additionally, the length of ICU stay, and total hospital stay were significantly shorter in the GDFT group, suggesting an overall improved recovery trajectory. Conclusion: The findings of this study suggest that perioperative Goal-Directed Fluid Therapy (GDFT) is associated with improved renal function, reduced incidence of postoperative AKI, and shorter hospital stays in high-risk surgical patients. The use of dynamic hemodynamic monitoring for individualized fluid administration appears to be superior to standard fixed-volume resuscitation strategies, potentially leading to better renal perfusion and organ protection. These results support the implementation of GDFT protocols in high-risk surgical populations to improve postoperative outcomes. Further multi-center trials with larger patient cohorts are needed to establish standardized GDFT guidelines for optimizing perioperative renal protection strategies.

Introduction: Chronic kidney disease is classified into five stages based on the estimated glomerular filtration rate (eGFR), with stage 1 being the mildest and stage 5 representing end-stage renal disease (ESRD). Microalbuminuria is typically detected in the early stages of CKD and is defined as a urinary albumin-to-creatinine ratio (ACR) between 30 and 300 mg/g. It is indicative of glomerular injury and endothelial dysfunction, reflecting increased permeability of the glomerular filtration barrier. The pathophysiology of microalbuminuria in CKD involves multiple factors, including glomerular hypertension, podocyte injury, and inflammation. Persistent microalbuminuria is associated with a decline in renal function and an increased risk of cardiovascular events, making it an important marker for risk stratification and therapeutic monitoring in CKD patients.  Material and Methods:  This  is an Observational or cross-sectional study was conducted among CKD patients from outpatient clinics or hospitals, Index Medical College. Patients diagnosed with CKD stages 1–5, based on the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Demographic and Clinical Data: Collect information on age, gender, duration of CKD, comorbidities, medications, and lifestyle factors. Quantify urinary albumin excretion using spot urine samples or 24-hour urine collections. Normalize results to urinary creatinine concentration. Spot urine samples or 24-hour urine collections will be used to quantify urinary albumin excretion. Urinary albumin concentration will be measured using an immunoturbidimetric assay. Results Mean Urinary Albumin (mg/g creatinine) is 145.6 mg/g creatinine, SD: 85.3 and 24-hour Urinary Albumin (mg/day) is 320.4 mg/day, SD: 150.2. Both Urinary Albumin Measures Increase with CKD Progression: Urinary albumin (mg/g creatinine) rises from 45.2 mg/g (Stage 1) to 380.5 mg/g (Stage 5). 24-hour urinary albumin excretion shows a similar increase from 85.3 mg/day (Stage 1) to 600.5 mg/day (Stage 5). The rate of albumin increase is mild in Stages 1 & 2 but becomes steep in Stages 3-5. Urinary Albumin (mg/g creatinine) has a correlation of r=0.65r = 0.65r=0.65 (p < 0.001). 24-hour Urinary Albumin (mg/day) has an even stronger correlation of r=0.70r = 0.70r=0.70 (p < 0.001).  Conclusion This study demonstrates a significant negative correlation between antioxidant status and microalbuminuria in CKD patients, consistent with previous research. The findings highlight the role of oxidative stress in CKD progression and suggest that interventions targeting oxidative stress may help reduce microalbuminuria and slow disease progression

Background: A biomarker is a characteristic that is objectively measured and evaluated as an Indicator of normal biologic processes, pathogenic processes or pharmacologic responses to therapeutic intervention. Biomarkers may be prognostic predictive, pharmacodynamics or suggest clinical endpoint or Surrogate endpoint. The former ones are biomarkers Type 1, while the latter is biomarkers type 2. Serum cystatin C is a definitive biomarker indicating progression of disease and cardiovascular involvement. This is a type 1 biomarker, showing ESRD as the end point. Plasma levels of Transforming Growth Factor Receptor (TGFR-1) and Endothelial Growth Factor (EGF) are surrogate end point indicators and are examples of type 2. In the absence of advanced biochemical or genetic assays, clinical biochemistry offers effective alternative to indicate susceptibility, initiation and progression of kidney disease. In this study, serum Parathormone, serum uric acid along with serum creatinine levels were compared with indicators of right ventricular function such as RVSP and TAPSE to evaluate the effectiveness of the former as biomarkers of right ventricular dysfunction. Aims And Objectives: To evaluate serum levels of Parathormone, uric acid and creatinine as markers of right ventricular dysfunction in ESRD. To predict the severity of disorder by correlating the markers with RVSP, TAPSE and hemoglobin. Materials And Methods: Study: Retrospective analysis Study population: All patients with ESRD who presented for preanaesthetic check for renal transplantation.Study period: Dec ’24 to March ’25. Study place: DSMCH, Siruvachur, PERAMBALUR. Study sample: 30 Parameters Age, Gender, hemoglobin, RVSP (right ventricular systolic pressure), TAPSE (tricuspid annular plane systolic excursion), uric acid, creatinine, parathormone Methods: The preanaesthetic assessment charts along with routine work-up charts of thirty patients were analysed for the aforesaid parameters. The results were tabulated and compared. Results: A total of 30 patients who underwent successful renal transplantation in the above study period were examined for the aforesaid parameters. Most of them were in the age group of 35–40 years of age. The haemoglobin of males ranged from 7 to 9.5 g/dl and in females from 8.2 to 8.4 g/dl. The right ventricular systolic pressure was inversely proportional to the haemoglobin levels. The lowest hemoglobin of 6.4 g/dl had an RVSP of 58 mm Hg. From the scatter plot diagram below, we may appreciate more number of patients’ hemoglobin between 7.0 g/dl and 9.0 g/dl had RVSP between 30 to 50 mm Hg which is mild to moderate pulmonary hypertension (p = 0.185). TAPSE, which is more sensitive of right ventricular dysfunction, showed p of 0.123 with hemoglobin levels. Parathormone levels were more sensitive and statistically significant indicator of RVSP (right ventricular systolic pressure) (p = 0.132) than uric acid (p = 0.63) or creatinine (p = 0.53). Serum creatinine showed significant probability variation with TAPSE (0.177). Conclusion: Left ventricle is the earliest to be involved in chronic kidney disease, initially show as hypertrophy then progresses to left ventricular dilated cardiomyopathy. In End stage Renal disease, the severity, progression and cardiac dysfunction secondary to renal disorders is reflected as right ventricular dysfunction described in terms of RVSP and TAPSE by echocardiogram. A high serum parathormone level appears to signify pulmonary hypertension as increase in right ventricular systolic pressure (p = 0.132) and serum creatinine levels seems to be a sensitive indicator of right ventricular dysfunction by ablation of TAPSE (p = 0.177).