Relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients. Issue 2 (12th February 2019)

• Record Type: Journal Article
• Authors: Yong, Kenneth; Mori, Trevor; Chew, Gerard; Beilin, Lawrence J.; Puddey, Ian; Watts, Gerald; Dogra, Gursharan; Boudville, Neil; Lim, Wai
• Is Part Of: Internal medicine journal. Volume 49:Issue 2(2019)
• Page Start: 240
• Page End: 247
• Publication Date: 2019-02-12
• Subjects: arterial stiffness -- inflammation -- diastolic dysfunction -- chronic kidney disease; Medicine -- Periodicals; 616
• DOI: 10.1111/imj.14037
• Languages: English
• ISSNs: 1444-0903

Abstract

Abstract: Background: Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non‐traditional risk factors, such as arterial stiffness and inflammation, are implicated in the pathogenesis of DD in CKD patients. Aim: To determine the association between inflammatory markers (interleukin (IL)‐12, IL‐18, highly sensitive C‐reactive protein (hsCRP)) and non‐invasive markers of arterial stiffness (24‐h pulse pressure (PP)) with DD in stages 3–4 CKD patients. Methods: We performed a sub‐analysis of 78 non‐diabetic stages 3–4 CKD subjects to determine the relationship between 24‐h PP, IL‐12, IL‐18 and hsCRP with DD. Results: DD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0 ± 1.9 vs 50.2 ± 2.0 years; P < 0.001) and had higher 24‐h PP (48(95% confidence interval 45, 52) vs 43(95% confidence interval 41, 45) mmHg; P < 0.005); 24‐h PP was associated with DD ( P = 0.02), but this was no longer significant after adjustment for age ( P = 0.31). Serum IL‐12, IL‐18 and hsCRP levels were not significantly different between subjects with or without DD. Conclusion: Asymptomatic subclinical DD was present in 50% of a cohort of stages 3–4 CKD patients but was not associated with IL‐12, IL‐18 or hsCRP. The association between 24‐h PP and DD was no longer apparent following adjustment for age, but given the small sample size, our findings will need to be explored in larger‐sized cohorts of individuals with moderate‐stage CKD.