الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cardiovascular complications remain the most important cause of morbidity and mortality .Once an individual reaches end-stage renal disease(ESRD), cardiovascular disease (CVD) is responsible for approximately half of deaths( 1).
Our study included 140 person of both sexes, aged between15 years and 80 years old selected from our nephrology unit showing that
●Overall, 50% of the patients had at least one form of ECG abnormality. These include left ventricular hypertrophy (LVH) (35%), left atrial enlargement (P mitral) (6.4%), right ventricular hypertrophy (RVH)(3.6%), ischaemia(16.4%), sinus tachycardia (9.3),combination of LVH and LAE (2.14%), and ventricular premature contractions(PVC) (5%), and male gender appear to be more risky than female gender for the ECG abnormalities.
● And, 84.28% of the patients had at least one form of Echo. abnormality. These include left ventricular hypertrophy (LVH) (53.6%), left ventricular dilatation (7.9%), diastolic dysfunction (DD)(54.3%), right ventricular dysfunction(RVDD)(10%), dilated right side(5.7%), dilated left atrium (22.9%), pulmonary hypertension was seen in (6.4%) of the patients, pericardial effusion (PE)(14.3%) and ischaemia (15.7%).
Conclusion
LVH is very common electrocardiographic abnormalities in our CKD patients. HTN appear to be the main risk factors for that ECG abnormalities. There is need for specific intervention strategies directed at early detection and treatment of HTN and other risk factors of CKD, especially in resource poor nations where the burden of CKD is assuming epidemic proportion. This will ameliorate mortality from cardiovascular complications and delay progression of CKD to ESRD.
The set of evidence indicates the extraordinary role of the Doppler echocardiography in the improvement of the global clinical assessment quality of the patient with CKD undergoing dialysis. The literature and the clinical practice have emphasized the usefulness of the method in the diagnosis of subclinical heart dysfunction, in the refinement of the clinical diagnosis of heart failure, in the cardiovascular risk prediction and when establishing the course and follow-up of the treatment strategies.
The Doppler echocardiographic outcomes have shown to be useful substitute markers for prognosis and intervention studies. North-American directives recommend the Doppler echocardiogram for all patients undergoing dialysis one to three months after the start of the substitutive renal therapy and at three-year intervals subsequently, regardless of symptoms(197). Our opinion is that all patients initiating dialytic therapy must be submitted to an echocardiogram.
However, shorter intervals between evaluations can be of clinical value in individualized therapies. It has been demonstrated that the follow-up with seriate echocardiograms adds prognostic value beyond the basal assessment, enabling the monitoring of the regression or not of the LV alterations(198).
In the future, new Doppler echocardiographic methods with the capacity to investigate subclinical myocardial disease (such as strain, strain rate and ultrasonic tissue characterization) will further benefit this group of patients at excessive cardiovascular risk.