Evita Zevanya, Sudharmadji Sudharmadji


Chronic kidney disease is persistent abnormality or damage in kidney structure or function for more than 3 months. Prevalence of CKD is around 10 – 14% in general population and affects around more than 800 million individuals worldwide. Patients with CKD have higher risk of cardiovascular disease and synergistic pathological effects can speed up worsening of diseases. Radiology examination is one of the test that can be used to evaluate kidney and heart structural damage. The aim of this paper is to report chest rontgen findings in a man aged 54 years old with CKD with HF in 3 serials imaging result. Patient admitted to hospital caused by shortness of breath. Patient has history of hypertension, diabetes mellitus type 2, CKD stage V, and congestive heart failure. From physical examination, oxygen saturation was 97%, blood pressure was 154/115 mmHg, and extremity edema was found. Chest rontgen impression was bronchitis, dextra pleural effusion, and normal cardiac size. He got oxygen, Furosemide, Nicardipine, Aspirin, Irbesartan, Amlodipine, Calcium carbonate, and hemodialysis as therapies. After be hospitalized 2 days, patient’s condition was better, and therapy was continued outpatient. Chest rontgen examination result a year ago showed pulmonary edema, bilateral pleural effusion, and cardiomegaly with shortness of breath as major symptom. Chest rontgen examination result 6 months ago showed bronchopneumonia and cardiomegaly with fever, cough, nausea, and loss of appetite. In conclusion, most of CKD patients particularly in late stage have cardiovascular disease and radiology examination is important to detect and evaluate structural cardiac abnormality in CKD patients.
Keyword: Chest rontgen, chronic kidney disease, congestive heart failure.

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Chest rontgen, chronic kidney disease, congestive heart failure.

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Chen TK, Knicely DH, Grams ME. Chronic Kidney Disease Diagnosis and Management: A Review. JAMA. 2019 Oct 1;322(13):1294-1304.

Vaidya SR, Aeddula NR. Chronic Renal Failure. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:

Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022 Apr;12(1):7-11.

Mallappallil M, Friedman EA, Delano BG, McFarlane SI, Salifu MO. Chronic kidney disease in the elderly: evaluation and management. Clin Pract Lond Engl. 2014;11(5):525–35.

Tang B, Li s, Xiong Y, Tian M, Yu J, Xu L, et al. COVID-19 pneumonia in a HD patient. Kidney Med. 2020;2(3):354-8.

Oyelade T, Alqahtano J, Canciani G. Prognosis of COVID-19 in patients with liver and kidney diasease: an early systemic review and metaanalysis. Trop Med Infect Dis. 2020;5(80):1–14.

Grande D, Terlizzese P, Iacoviello M. Role of imaging in the evaluation of renal dysfunction in heart failure patients. World J Nephrol. 2017 May 6;6(3):123-131.

David KR, Debasish B, Fadi J. Management of Heart Failure in Patients with Chronic Kidney Disease. European Cardiology Review. 2022;17:e17.

Wong C, Chen S, Iyngkaran P. Cardiac Imaging in Heart Failure with Comorbidities. Curr Cardiol Rev. 2017;13(1):63-75.

Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. Lancet. 2017 Mar 25;389(10075):1238-1252.

Matovinović MS. 1. Pathophysiology and Classification of Kidney Diseases. EJIFCC. 2009 Apr 20;20(1):2-11.

Wouters OJ, O’Donoghue DJ, Ritchie J, Kanavos PG, Narva AS. 2015. Early chronic kidney disease: diagnosis, management and models of care. Nat Rev Nephrol. 2015 August; 11(8): 491–502.

Chiu DY, Green D, Abidin N, Sinha S, Kalra PA. Cardiac imaging in patients with chronic kidney disease. Nat Rev Nephrol. 2015 Apr;11(4):207-20.

Jankowski J, Floege J, Fliser D, Bohm M, Marx N. Cardiovascular Disease in Chronic Kidney Disease Pathophysiological Insights and Therapeutic Options. Circulation. 2021;143:1157–1172.

Hakopian NN, Gharibian D, Nashed MM. Prognostic Impact of Chronic Kidney Disease in Patients with Heart Failure. Perm J. 2019;23:18-273.

Utami SN, Uli HM, Septadiana IS. Pathological Findings in Chest Radiographs of Chronic Kidney Disease Patients Undergoing Hemodialysis. SJM, 2021, 4(1):38-45.

PERKI. Pedoman Tatalaksana Gagal Jantung (1st ed.). 2015. Jakarta: Perhimpunan Dokter Spesialis Kardiovaskular Indonesia.

Mant J, Doust J, Roalfe A, Barton P, Cowie MR, Glasziou P, et al. Systematic Review and Individual Patient Data Meta-Analysis of Diagnosis of Heart Failure, with Modelling of Implications of Different Diagnostic Strategies in Primary Care. Health Technol. Assess. 2009, 13, 1–207.

Siwik D, Apanasiewicz W, Zukowska M, Jaczewski G, Dabrowska M. Diagnosing Lung Abnormalities Related to Heart Failure in Chest Radiogram, Lung Ultrasound and Thoracic Computed Tomography. Adv Respir Med, 2023, 91(2):103-122.

Sureka B, Bansal K, Arora A. Pulmonary edema - cardiogenic or noncardiogenic?. J Family Med Prim Care. 2015 Apr-Jun;4(2):290.

Shen L, Jhund PS, Anand IS, Bhatt AS, Desai AS, Maggioni AP et al. Incidence and Outcomes of Pneumonia in Patients With Heart Failure. J Am Coll Cardiol. 2021 Apr 27;77(16):1961-1973.

Pant A, Prasai A, Rauniyar AK, Adhikary L, Basnet K, Khadka T. Pneumonia in Patients with Chronic Kidney Disease Admitted to Nephrology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021 Oct 15;59(242):1000-1003.

Xu Y, Liu Y, Zhang X, Zhang X, Du J, Cai Y, et al. Epidemiology of varicella and effectiveness of varicella vaccine in Hangzhou, China, 2019. Hum Vaccin Immunother. 2021 Jan 2;17(1):211-216.

Cersosimo A, Riccardi M, Amore L, Cimino G, Arabia G, Metra M, et al. Varicella zoster virus and cardiovascular diseases. Monaldi Arch Chest Dis. 2022 Sep, 21;93(2).