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Serum alkaline phosphatase levels and left ventricular diastolic dysfunction in patients with advanced chronic kidney

Olimpia Ortega1, Isabel Rodriguez, Julie Hinostroza

  • 1Nephrology Service, Hospital Severo Ochoa, Leganes, Spain.

Nephron Extra
|April 4, 2012
PubMed

Insights

Elevated alkaline phosphatase (ALP) in advanced chronic kidney disease (CKD) may stem from liver congestion due to heart issues. Treating fluid overload can lower ALP levels, suggesting a link between heart function and liver health in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Hepatology

Background:

  • High alkaline phosphatase (ALP) levels are linked to increased mortality in advanced chronic kidney disease (CKD).
  • Subclinical liver congestion due to left ventricular diastolic dysfunction is hypothesized as a cause for elevated ALP.
  • Understanding this link is crucial for managing CKD patient outcomes.

Purpose of the Study:

  • To investigate the association between left ventricular diastolic dysfunction and elevated alkaline phosphatase (ALP) in advanced chronic kidney disease (CKD).
  • To explore the impact of fluid overload and diuretic treatment on ALP levels in this patient population.

Main Methods:

  • Doppler echocardiography was used in 68 advanced CKD patients.
  • Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) levels were compared between patients with and without diastolic dysfunction.
  • The effect of intensified diuretic treatment on ALP was assessed in a subgroup.

Main Results:

  • ALP significantly correlated with GGT but not parathyroid hormone.
  • Patients with diastolic dysfunction had higher ALP, GGT, and lower albumin levels.
  • Intensified diuretic therapy reduced body weight, GGT, and ALP levels in fluid-overloaded patients.

Conclusions:

  • Elevated ALP in advanced CKD may be partly due to subclinical liver congestion from left ventricular diastolic dysfunction and/or hypervolemia.
  • Myocardial damage might explain the poorer prognosis observed in these patients.
  • Targeting fluid overload could be a therapeutic strategy to reduce ALP levels.
Abstract

Keywords:
Alkaline phosphataseChronic kidney diseaseHypervolemiaLeft-ventricular dysfunctionLiver congestion

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