Relationship between arterial stiffness, left ventricular diastolic function, and renal function in chronic kidney disease

BMC Nephrology

Research

Balázs Sági¹  Botond Csiky¹  Tibor József Kovács¹  Judit Nagy¹  Tibor Vas¹  István Késői² 

[1] 2nd Dept. of Internal Medicine and Nephrology, Diabetes Centre, Medical School, Clinical Center, University of Pécs, Pacsirta Street 1, 7624, Pécs, Hungary;Mohács Hospital, Department of Internal Medicine Cardiology, Szepessy square 7, 7700, Mohács, Hungary;

关键词: Arterial stiffness;    Chronic kidney disease;    Echocardiography, Doppler;    IgA nephropathy;    Left ventricular diastolic dysfunction;   

DOI  :  10.1186/s12882-023-03308-w

 received in 2023-06-12, accepted in 2023-08-24,  发布年份 2023

来源: Springer

【 摘 要 】

AimIn chronic kidney disease, IgA nephropathy, and left ventricular diastolic dysfunction have prognostic significance as well. However, the relationship between diastolic dysfunction, arterial stiffness, and renal function has not been fully elucidated.Methods79 IgA nephropathy patients (aged 46 ± 11 years) and 50 controls were investigated. Tissue Doppler imaging was used to measure early (Ea) and late (Aa) diastolic velocities. Arterial stiffness was measured by a photoplethysmographic (stiffness index (SI)) and an oscillometric method (aortic pulse wave velocity (PWVao)).ResultsWe compared the IgAN patients to a similar cardiovascular risk group with a preserved eGFR. A strong correlation was found between Ea/Aa and SI (p < 0.001), also with PWVao (p < 0.001), just in IgAN, and with eGFR (p < 0.001) in both groups. IgAN patients were divided into groups CKD1-2 vs. CKD3-5. In the CKD 3–5 group, the incidence of diastolic dysfunction increased significantly: 39% vs. 72% (p = 0.003). Left ventricle rigidity (LVR) was calculated, which showed a close correlation with SI (p = 0.009) and eGFR (p = 0.038). By linear regression analysis, the independent predictors of SI were age, E/A, and E/Ea; SI was the predictor of LVR; and E/A and hypertension were the predictors of eGFR.ConclusionIn chronic kidney disease, increased cardiac rigidity and vascular stiffness coexist with decreased renal function, which is directly connected to diastolic dysfunction and vascular stiffness. On the basis of comparing the CKD group to the control group, vascular alterations in very early CKD can be identified.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 1