Is echocardiography mandatory for patients with chronic kidney disease?

Abstract:

:This study aims at evaluating the prevalence of left ventricular diastolic dysfunction in a group of 319 hypertensive patients with stage 3b-4-5 chronic kidney disease (according to Kidney Disease Improving Global Outcomes classification), compared with 216 patients with essential hypertension and normal renal function. All patients underwent echocardiographic examination. Patients on stage 1-2-3a chronic kidney disease, dialysis treatment, or with previous manifestations of heart failure or other cardiovascular diseases were excluded. Patients with renal disease had significantly worse diastolic function (both considering trans-mitral flow and tissue Doppler imaging parameters). Diastolic dysfunction is found in 70.5% of the CKD group and in 41.6% of hypertensive patients (p < 0.0001). Multiple regression analysis shows an association between renal function and diastolic function (β 0.223; p < 0.0001), independent of potential confounders. Our study shows that diastolic dysfunction is highly prevalent in patients with advanced chronic kidney disease; we posit that in this population, the risk of diastolic heart failure is very high. We think that patients with a marked decrease of glomerular filtration rate (GFR) must be considered at high risk for diastolic heart failure and should have an echocardiographic examination performed, even if asymptomatic and in the absence of evident cardiovascular disease.

journal_name

Intern Emerg Med

authors

Nardi E,Mulè G,Nardi C,Geraci G,Giammanco A,Bentivegna R,Averna M

doi

10.1007/s11739-019-02028-0

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

923-929

issue

6

eissn

1828-0447

issn

1970-9366

pii

10.1007/s11739-019-02028-0

journal_volume

14

pub_type

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