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

• Published in: BMC nephrology 2023-09, Vol.24 (1), p.1-261, Article 261
• Main Authors: Sági, Balázs, Késői, István, Vas, Tibor, Csiky, Botond, Nagy, Judit, Kovács, Tibor József
• Format: Article
• Language: English
• Subjects: Aorta; Arterial stiffness; Blood pressure; Cardiovascular diseases; Care and treatment; Chronic kidney disease; Chronic kidney failure; Complications and side effects; Coronary artery disease; Diabetes; Doppler effect; Echocardiography, Doppler; Epidermal growth factor receptors; Health aspects; Heart diseases; Heart failure; Hypertension; IgA glomerulonephritis; IgA nephropathy; Immunoglobulin A; Kidney diseases; Left ventricular diastolic dysfunction; Measurement; Metabolism; Mortality; Nephrology; Patients; Prevention; Regression analysis; Renal function; Risk factors; Statistical analysis; Transplants & implants; Velocity; Ventricle
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-023-03308-w

Aim In 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. Methods 79 IgA nephropathy patients (aged 46 [+ or -] 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)). Results We 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. Conclusion In 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. Keywords: Arterial stiffness, Chronic kidney disease, Echocardiography, Doppler, IgA nephropathy, Left ventricular diastolic dysfunction