Prevalence of cardiovascular risk factors among chronic kidney disease patients undergoing hemodialysis in a tertiary care center, Kathmandu, Nepal

Article


Pokhrel, A., Gyawali, P., Pokhrel, B. R., Khanal, M. P., Manandhar, D. N., Bwititi, P. and Nwose, E. U.. 2019. "Prevalence of cardiovascular risk factors among chronic kidney disease patients undergoing hemodialysis in a tertiary care center, Kathmandu, Nepal." Nepal Medical College Journal. 21 (4), pp. 313-318. https://doi.org/10.3126/nmcj.v21i4.27629
Article Title

Prevalence of cardiovascular risk factors among chronic kidney disease patients undergoing hemodialysis in a tertiary care center, Kathmandu, Nepal

Article CategoryArticle
AuthorsPokhrel, A. (Author), Gyawali, P. (Author), Pokhrel, B. R. (Author), Khanal, M. P. (Author), Manandhar, D. N. (Author), Bwititi, P. (Author) and Nwose, E. U. (Author)
Journal TitleNepal Medical College Journal
Journal Citation21 (4), pp. 313-318
Number of Pages6
Year2019
Place of PublicationNepal
Digital Object Identifier (DOI)https://doi.org/10.3126/nmcj.v21i4.27629
Abstract

The risk of cardiovascular disease is higher in chronic kidney disease patients compared to the general population and its impact is higher in developing countries compared to the developed countries. With this background in mind, we aimed to evaluate the prevalence of different cardiovascular risk factors in patients on maintenance hemodialysis in a tertiary care center. Chronic kidney disease patients aged 18 years and above who were under maintenance hemodialysis in the hemodialysis unit of Nepal Medical College were included in the study. Pre-dialysis venous blood samples from the participants were collected and analyzed for serum calcium, phosphorus, total protein, albumin and hemoglobin. Calcium phosphate product was calculated. Out of 100 study participants, 52% were male and 48% were female. Age-wise distribution showed 38% of the participants were below 40 years. The mean age of the participants was 45.86 ± 14.4 years. Ninety-three percent had hypertension and 29% had diabetes mellitus. Hypocalcemia was present in 80%, hyperphosphatemia was seen among 81% and high calcium phosphate product was present in 33% of the participants. Low hemoglobin (< 10gm/dL) was found in 86%. The cardiovascular risk trend in the Nepalese chronic kidney disease population is fairly different compared to the western population. Participants were younger. Prevalence of hypertension and diabetes was high. The high prevalence of anemia might be due to unaffordability of the participants for regular erythropoietin therapy. Inadequately managed hyperphosphatemia despite the widespread use of phosphorus binders, is still a major clinical challenge in patients on hemodialysis.

Keywordscardiovascular risk, chronic kidney disease, hemodialysis, anemia, calcium phosphate product product
ANZSRC Field of Research 2020320101. Cardiology (incl. cardiovascular diseases)
Byline AffiliationsNepal Medical College and Teaching Hospital
University of Newcastle
Universal College of Medical Sciences and Teaching Hospital, Nepal
Charles Sturt University
Institution of OriginUniversity of Southern Queensland
Permalink -

https://research.usq.edu.au/item/q5y59/prevalence-of-cardiovascular-risk-factors-among-chronic-kidney-disease-patients-undergoing-hemodialysis-in-a-tertiary-care-center-kathmandu-nepal

Download files


Published Version
CVD in CKD NMCJ .pdf
License: CC BY 4.0
File access level: Anyone

  • 209
    total views
  • 102
    total downloads
  • 3
    views this month
  • 13
    downloads this month

Export as

Related outputs

An Evaluation of Community Health Workers’ Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception
Yenit, Melaku Kindie, Kolbe-Alexander, Tracy L., Gelaye, Kassahun Alemu, Gezie, Lemma Derseh, Tesema, Getayeneh Antehunegn, Abebe, Solomon Mekonnen, Azale, Telake, Shitu, Kegnie and Gyawali, Prajwal. 2023. "An Evaluation of Community Health Workers’ Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception." International Journal of Environmental Research and Public Health. 20 (9). https://doi.org/10.3390/ijerph20095642
Editorial: Stress, mood, and fatigue: Tackling “invisible” obstacles in stroke rehabilitation and recovery
Gyawali, Prajwal, Wong, Dana, Hordacre, Brenton, Ong, Lin Kooi and English, Coralie. 2023. "Editorial: Stress, mood, and fatigue: Tackling “invisible” obstacles in stroke rehabilitation and recovery ." Frontiers in Neurology. 13. https://doi.org/10.3389/fneur.2022.1121667
Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke
Gyawali, Prajwal, Lillicrap, Thomas P., Garcia-Esperon, Carlos G., Bhattarai, Aseem, Bivard, Andrew and Spratt, Neil. 2023. "Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke." Seminars in Thrombosis and Hemostasis. https://doi.org/10.1055/s-0043-1775858
Drug-Resistant Tuberculosis Stigma Among HealthCare Workers Toward the Development of a Stigma-Reduction Strategy: A Scoping Review
Aranas, Lolita Liboon, Alam, Khorshed, Gyawali, Prajwal and Mahumud, Rashidul Mahumud. 2023. "Drug-Resistant Tuberculosis Stigma Among HealthCare Workers Toward the Development of a Stigma-Reduction Strategy: A Scoping Review." Inquiry: the Journal of Health Care Organization Provision and Financing. 60, pp. 1-10. https://doi.org/10.1177/00469580231180754
Scoping review of molecular biomarkers associated with fatigue, stress, and depression in stroke survivors: A protocol
Potter, Tarynn, Gange, Nisal, Whiteside, Eliza and Gyawali, Prajwal. 2023. "Scoping review of molecular biomarkers associated with fatigue, stress, and depression in stroke survivors: A protocol." PLoS One. 18. https://doi.org/10.1371/journal.pone.0281238.
Examining Drug-Resistant Tuberculosis Stigma Among Health Care Workers Toward the Development of a Stigma-Reduction Intervention: Protocol for a Scoping Review
Aranas, Lolita Liboon, Alam, Khorshed, Gyawali, Prajwal and Mahumud, Rashidul Alam. 2023. "Examining Drug-Resistant Tuberculosis Stigma Among Health Care Workers Toward the Development of a Stigma-Reduction Intervention: Protocol for a Scoping Review ." JMIR Research Protocols. 12, p. e43084. https://doi.org/10.2196/43084
Successful health promotion, its challenges and the way forward in Nepal
Dhital, Madhu Koirala, Dhital, Shalik Ram, KC, Bhakta Bahadur, Owens, Vicki, Khadka, Hem Raj and Gyawali, Prajwal. 2022. "Successful health promotion, its challenges and the way forward in Nepal." Global Health Promotion. 30 (1), pp. 68-71. https://doi.org/10.1177/17579759221117792
Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review
Hinwood, Madeleine, Ilicic, Marina, Gyawali, Prajwal, Coupland, Kirsten, Kluge, Murielle G., Smith, Angela, Bowden, Sue, Nilsson, Michael and Walker, Frederick Rohan. 2023. "Psychological Stress Management and Stress Reduction Strategies for Stroke Survivors: A Scoping Review." Annals of Behavioral Medicine. 57 (2), p. 111–130. https://doi.org/10.1093/abm/kaac002
Exploring the relationship between fatigue and circulating levels of the pro-inflammatory biomarkers interleukin-6 and C-reactive protein in the chronic stage of stroke recovery: a cross-sectional study
Gyawali, Prajwal, Hinwood, Madeleine, Chow, Wei Zhen, Kluge, Murielle, Ong, Lin Kooi, Nilsson, Michael and Walker, Frederick Rohan. 2020. "Exploring the relationship between fatigue and circulating levels of the pro-inflammatory biomarkers interleukin-6 and C-reactive protein in the chronic stage of stroke recovery: a cross-sectional study." Brain, Behavior, & Immunity - Health. 9, pp. 1-6. https://doi.org/10.1016/j.bbih.2020.100157
Dyslipidemia among Patients with Ischemic Stroke in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
Baral, Sushil, Pokhrel, Asmita, Kumar B.K., Shyam, Kshetri, Rupesh, Regmi, Prashant and Gyawali, Prajwal. 2022. "Dyslipidemia among Patients with Ischemic Stroke in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study." Journal of the Nepal Medical Association. 60 (250), pp. 511-516. https://doi.org/10.31729/jnma.7491
Address an unmet need: establishing the prevalence of metabolic syndrome in Darling Down region
Gardiner, P., Aung, N., Ng, L., Stolic, S., Bliss, E., Gyawali, P. and Roberts, M.. 2022. "Address an unmet need: establishing the prevalence of metabolic syndrome in Darling Down region." Toowoomba, Darling Downs Health Services Research Symposium.
Cardiovascular Risk Assessment in Hemodialysis Patients
Pokhrel, Asmita, Pokhrel, Buddhi Raj, Gyawali, Prajwal, Regmi, Deepak, Khanal, Madhav, Bhattarai, Ashim, Poudel, Prakash and KC, Anuj. 2021. "Cardiovascular Risk Assessment in Hemodialysis Patients." Nepal Medical College Journal. 23 (3), pp. 252-258. https://doi.org/10.3126/nmcj.v23i3.40385
Whole blood viscosity is associated with baseline cerebral perfusion in acute ischemic stroke
Gyawali, Prajwal, Lillicrap, Thomas Patrick, Tomari, Shinya, Bivard, Andrew, Holliday, Elizabeth, Parsons, Mark, Levi, Christopher, Garcia-Esperon, Carlos and Spratt, Neil. 2022. "Whole blood viscosity is associated with baseline cerebral perfusion in acute ischemic stroke." Neurological Sciences. 43 (4), pp. 2375-2381. https://doi.org/10.1007/s10072-021-05666-5
Role of purinergic signalling in endothelial dysfunction and thrombo-inflammation in ischaemic stroke and cerebral small vessel disease
Lee, Natasha Ting, Ong, Lin Kooi, Gyawali, Prajwal, Nassir, Che Mohd Nasril Che Mohd, Mustapha, Muzaimi, Nandurkar, Harshal H. and Sashindranath, Maithili. 2021. "Role of purinergic signalling in endothelial dysfunction and thrombo-inflammation in ischaemic stroke and cerebral small vessel disease." Biomolecules. 11 (7). https://doi.org/10.3390/biom11070994
Acute Effects of Frequent Light-Intensity Standing-Based Exercises That Interrupt 8 Hours of Prolonged Sitting on Postprandial Glucose in Stroke Survivors: A Dose-Escalation Trial
Mackie, Paul, Crowfoot, Gary, Gyawali, Prajwal, Janssen, Heidi, Holliday, Elizabeth, Dunstan, David and English, Coralie. 2021. "Acute Effects of Frequent Light-Intensity Standing-Based Exercises That Interrupt 8 Hours of Prolonged Sitting on Postprandial Glucose in Stroke Survivors: A Dose-Escalation Trial." Journal of Physical Activity and Health. 18 (6), pp. 644-652. https://doi.org/10.1123/jpah.2020-0516
Time-efficient intervention to improve older adolescents’ cardiorespiratory fitness: findings from the ‘Burn 2 Learn’ cluster randomised controlled trial
Lubans, David R., Smith, Jordan J., Eather, Narelle, Leahy, Angus A., Morgan, Philip J., Lonsdale, Chris, Plotnikoff, Roland C., Nilsson, Michael, Kennedy, Sarah G., Holliday, Elizabeth G., Weaver, Natasha, Noetel, Michael, Shigeta, Tatsuya T., Mavilidi, Myrto F., Valkenborghs, Sarah R., Gyawali, Prajwal, Walker, Frederick R., Costigan, Sarah A. and Hillman, Charles H.. 2020. "Time-efficient intervention to improve older adolescents’ cardiorespiratory fitness: findings from the ‘Burn 2 Learn’ cluster randomised controlled trial." British Journal of Sports Medicine. https://doi.org/10.1136/bjsports-2020-103277
Similar cognitive deficits in mice and humans in the chronic phase post-stroke identified using the touchscreen-based paired-associate learning task
Chow, Wei Zhen, Ong, Lin Kooi, Kluge, Murielle G., Gyawali, Prajwal, Walker, Frederick R. and Nilsson, Michael. 2020. "Similar cognitive deficits in mice and humans in the chronic phase post-stroke identified using the touchscreen-based paired-associate learning task." Scientific Reports. 10, pp. 1-8. https://doi.org/10.1038/s41598-020-76560-x
Plasmin Generation Potential and Recanalization in Acute Ischaemic Stroke; an Observational Cohort Study of Stroke Biobank Samples
Lillicrap, Thomas, Keragala, Charithani B., Draxler, Dominik F., Chan, Jilly, Ho, Heidi, Harman, Stevi, Niego, Be’eri, Holliday, Elizabeth, Levi, Christopher R., Garcia-Esperon, Carlos, Spratt, Neil, Gyawali, Prajwal, Bivard, Andrew, Parsons, Mark W., Montaner, Joan, Bustamante, Alejandro, Cadenas, Israel Fernandez, Cloud, Geoffrey, Maguire, Jane M., ..., Medcalf, Robert L.. 2020. "Plasmin Generation Potential and Recanalization in Acute Ischaemic Stroke; an Observational Cohort Study of Stroke Biobank Samples." Frontiers in Neurology. 11, pp. 1-4. https://doi.org/10.3389/fneur.2020.589628
Accuracy of glucose meter among adults in a semi-urban area in Kathmandu, Nepal
Pokhrel, Asmita, Silvanus, Vinutha, Pokhrel, Buddhi Raj, Baral, Binaya, Khanal, Madhav, Gyawali, Prajwal, Pokhrel, Laxman and Regmi, Deepak. 2019. "Accuracy of glucose meter among adults in a semi-urban area in Kathmandu, Nepal." Nepal Medical Association Journal. 57 (216), pp. 104-108. https://doi.org/10.31729/jnma.4247
Hemorheological parameters better classify metabolic syndrome than novel cardiovascular risk factors and peripheral vascular disease marker
Gyawali, Prajwal, Richards, Ross S., Tinley, Paul, Nwose, Ezekiel Uba and Bwititi, Phillip T.. 2016. "Hemorheological parameters better classify metabolic syndrome than novel cardiovascular risk factors and peripheral vascular disease marker." Clinical Hemorheology and Microcirculation. 64 (1), pp. 1-5. https://doi.org/10.3233/CH-152033
Prediabetes and cardiovascular complications study (PACCS): international collaboration 4 years' summary and future direction
Nwose, E. U., Richards, R. S., Bwititi, P. T., Igumbor, E. O., Oshionwu, E. J., Okolie, K., Onyia, I. C., Pokhrel, A., Gyawali, P., Okuzor, J. N., Oguoma, V. M., Gardiner, F. W. and Wang, L.. 2017. "Prediabetes and cardiovascular complications study (PACCS): international collaboration 4 years' summary and future direction." BMC Research Notes. 10 (1). https://doi.org/10.1186/s13104-017-3017-7
School-based physical activity intervention for older adolescents: rationale and study protocol for the Burn 2 Learn cluster randomised controlled trial
Leahy, Angus A, Eather, Narelle, Smith, Jordan J, Hillman, Charles, Morgan, Philip J, Nilsson, Michael, Lonsdale, Chris, Plotnikoff, Ronald C, Noetel, Michael, Holliday, Elizabeth, Shigeta, Tatsuya T, Costigan, Sarah A, Walker, Frederick R, Young, Sarah, Valkenborghs, Sarah R, Gyawali, Prajwal, Harris, Nigel, Kennedy, Sarah G and Lubans, David R. 2019. "School-based physical activity intervention for older adolescents: rationale and study protocol for the Burn 2 Learn cluster randomised controlled trial." BMJ Open. 9 (5). https://doi.org/10.1136/bmjopen-2018-026029
Exploration of stress management interventions to address psychological stress in stroke survivors: A protocol for a scoping review
Hinwood, Madeleine, Ilicic, Marina, Gyawali, Prajwal, Kluge, Murielle Gabriela, Coupland, Kirsten, Smith, Angela, Nilsson, Michael and Walker, Frederick Rohan. 2020. "Exploration of stress management interventions to address psychological stress in stroke survivors: A protocol for a scoping review." BMJ Open. 10 (3). https://doi.org/10.1136/bmjopen-2019-035592
Opposing associations of stress and resilience with functional outcomes in stroke survivors in the chronic phase of stroke: A cross-sectional study
Gyawali, Prajwal, Chow, Wei Zhen, Hinwood, Madeleine, Kluge, Murielle, English, Coralie, Ong, Lin Kooi, Nilsson, Michael and Walker, Frederick Rohan. 2020. "Opposing associations of stress and resilience with functional outcomes in stroke survivors in the chronic phase of stroke: A cross-sectional study." Frontiers in Neurology. 11, pp. 1-12. https://doi.org/10.3389/fneur.2020.00230
Cardiovascular risk screening options in diabetes: framework for selective adoption
Nwose, Ezekiel U., Digban, Kester A., Oshionwu, Echinei J., Onyia, Innocent C., Bwititi, Phillip T., Oguoma, Victor M., Anyasodor, Anayochukwu E. and Gyawali, Prajwal. 2016. "Cardiovascular risk screening options in diabetes: framework for selective adoption." National Journal of Community Medicine. 7 (6), pp. 540-544.
Current research on cigarette toxicity: critical appraisal in view of clinical laboratory
Gyawali, Prajwal and Oguoma, Victor Maduabuchi. 2016. "Current research on cigarette toxicity: critical appraisal in view of clinical laboratory." International Journal of Research in Medical Sciences. 4 (6), pp. 1785-1793. https://doi.org/10.18203/2320-6012.ijrms20161725
Comparison of lipid profile parameters and oxidized low-density lipoprotein between normal and preeclamptic pregnancies in a tertiary care hospital in Nepal
Timalsina, Santosh, Gyawali, Prajwal and Bhattarai, Aseem. 2016. "Comparison of lipid profile parameters and oxidized low-density lipoprotein between normal and preeclamptic pregnancies in a tertiary care hospital in Nepal." International Journal of Women's Health. 8, pp. 627-631. https://doi.org/10.2147/IJWH.S117850
Quantitative Measurement of Erythrocyte Aggregation as a Systemic Inflammatory Marker by Ultrasound Imaging: A Systematic Review
Gyawali, Prajwal, Ziegler, Daniela, Cailhier, Jean-Franois, Denault, Andre and Cloutier, Guy. 2018. "Quantitative Measurement of Erythrocyte Aggregation as a Systemic Inflammatory Marker by Ultrasound Imaging: A Systematic Review." Ultrasound in Medicine and Biology. 44 (7), pp. 1303-1317. https://doi.org/10.1016/j.ultrasmedbio.2018.02.020
Hemorheology, ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) in metabolic syndrome
Gyawali, Prajwal, Richards, Ross S., Tinley, Paul and Nwose, Ezekiel Uba. 2014. "Hemorheology, ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) in metabolic syndrome ." Microvascular Research. 95, pp. 31-36. https://doi.org/10.1016/j.mvr.2014.06.013
Product of serum calcium and phosphorus (Ca× PO4) as predictor of cardiovascular disease risk in predialysis patients
Regmi, Prashant, Malla, Bimala, Gyawali, Prajwal, Sigdel, Manoj, Shrestha, Rojeet, Shah, Dibya Singh and Khanal, Madhav Prasad. 2014. "Product of serum calcium and phosphorus (Ca× PO4) as predictor of cardiovascular disease risk in predialysis patients." Clinical Biochemistry. 47 (1-2), pp. 77-81. https://doi.org/10.1016/j.clinbiochem.2013.09.012
Erythrocyte aggregation and metabolic syndrome
Gyawali, Prajwal, Richards, Ross S., Hughes, Diane L. and Tinley, Paul. 2014. "Erythrocyte aggregation and metabolic syndrome." Clinical Hemorheology and Microcirculation. 57 (1), pp. 73-83. https://doi.org/10.3233/CH-131792
Whole-blood viscosity and metabolic syndrome
Gyawali, Prajwal, Richards, Ross S, Nwose, Ezekiel Uba and Bwititi, Phillip T. 2012. "Whole-blood viscosity and metabolic syndrome ." Clinical Lipidology. 7 (6), pp. 709-719. https://doi.org/10.2217/CLP.12.65
Erythrocyte morphology in metabolic syndrome
Gyawali, Prajwal, Richards, Ross S. and Nwose, Ezekiel Uba. 2012. "Erythrocyte morphology in metabolic syndrome ." Expert Review of Hematology. 5 (5), pp. 523-531. https://doi.org/10.1586/EHM.12.47