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Is echocardiography mandatory for patients with chronic kidney disease?

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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.

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Authors and Affiliations

  1. Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Università degli Studi di Palermo, Via Alcide De Gasperi 30, 90146, Palermo, Italy

    Emilio Nardi, Giuseppe Mulè, Chiara Nardi, Giulio Geraci, Antonina Giammanco, Riccardo Bentivegna & Maurizio Averna

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  1. Emilio Nardi
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  2. Giuseppe Mulè
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Correspondence to Emilio Nardi.

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Nardi, E., Mulè, G., Nardi, C. et al. Is echocardiography mandatory for patients with chronic kidney disease?. Intern Emerg Med 14, 923–929 (2019). https://doi.org/10.1007/s11739-019-02028-0

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