Related Experiment Video
Updated: May 8, 2026
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
Hypocalcemia is related to left ventricular diastolic dysfunction in patients with chronic kidney disease
Leszek Gromadziński1, Beata Januszko-Giergielewicz2, Piotr Pruszczyk3
1Department of Internal Diseases, Gastroenterology and Hepatology, University Clinical Hospital in Olsztyn, Poland; Department of Internal Diseases, Gastroenterology, Cardiology and Infectiology, University of Warmia and Mazury in Olsztyn, Poland.
Insights
Hypocalcemia, or low calcium levels, is a significant predictor of left ventricular diastolic dysfunction in chronic kidney disease (CKD) patients. This finding highlights the importance of monitoring calcium levels in CKD management to prevent heart failure.
Area of Science:
- Nephrology
- Cardiology
- Clinical Biochemistry
Background:
- Left ventricular (LV) diastolic dysfunction is a major cause of heart failure in chronic kidney disease (CKD) patients.
- The complex interplay between calcium-phosphorus (Ca-P) metabolism and cardiac function in CKD requires further investigation.
Purpose of the Study:
- To investigate the impact of calcium-phosphorus metabolism disturbances on LV diastolic function in CKD patients.
- To assess LV diastolic function using echocardiography in relation to serum calcium levels.
Main Methods:
- Eighty-one ambulatory CKD patients (stages 2-5) with preserved LV systolic function were studied.
- Echocardiography, including tissue Doppler, measured LV diastolic velocities (EmLV, AmLV).
- Serum levels of creatinine, urea, phosphorus, calcium, parathormone, hemoglobin, and NT-proBNP were analyzed.
Main Results:
- Patients with LV diastolic dysfunction (EmLV<8cm/s) exhibited lower serum calcium (Ca) and higher NT-proBNP levels compared to those without.
- Serum Ca level ≤9.82mg/dL was identified as a sensitive (91.8%) and specific (38.1%) indicator for LV diastolic dysfunction.
- Multivariate logistic regression identified serum Ca level ≤9.82mg/dL as the sole independent predictor of LV diastolic dysfunction (OR=8.81, p=0.014).
Conclusions:
- Hypocalcemia is an independent predictive factor for LV diastolic dysfunction in CKD patients.
- Monitoring serum calcium levels is crucial for identifying and managing LV diastolic dysfunction in this population.
Background:
Left ventricular (LV) diastolic dysfunction in patients with chronic kidney disease (CKD) is of a complex nature and is the predominant cause of congestive heart failure in this group of patients. This work aimed to evaluate the potential effect of disturbances in calcium-phosphorus (Ca-P) metabolism in patients with CKD on LV diastolic function as assessed by echocardiography.
Materials And Methods:
The study group consisted of 81 ambulatory patients with CKD, stages 2-5, with preserved LV systolic function-LV ejection fraction >50% and with sinus rhythm. Standard echocardiography was performed in all patients with tissue Doppler echocardiography for the evaluation of the systolic velocity and both diastolic velocities of LV (EmLV and AmLV). The following laboratory parameters were measured: serum creatinine concentration, estimated glomerular filtration rate, and the levels of urea, P, Ca, parathormone, platelet count, hemoglobin level, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Patients were divided into two groups according to the results of EmLV: group with LV diastolic dysfunction (EmLV<8cm/s) DF (+) and group with normal LV diastolic function DF (-), when EmLV was ≥8cm/s.
Results:
Patients in DF (+) group, as compared to DF (-) patients, manifested a lower serum Ca level and an elevated NT-proBNP level [9.03±0.76mg/dL vs 9.44±0.78mg/dL, p=0.02, and 257.9 (32.6-12,633)pg/ml vs 149 (11.7-966)pg/ml, p=0.035, respectively]. The area under the receiver operating characteristics (ROC) curve of Ca for diastolic dysfunction was 0.627, 95% CI (0.511-0.734), p=0.04, whereas ROC derived Ca value of ≤9.82mg/dL was characterized by a sensitivity of 91.8% and specificity of 38.1% for diagnosing LV diastolic dysfunction. The only independent variable predicting LV diastolic dysfunction as measured by a multivariate logistic regression analysis was Ca level≤9.82mg/dL with odds ratio=8.81 (95% CI 1.49-51.82), p=0.014.
Conclusions:
Hypocalcemia is an independent predictive factor for LV diastolic dysfunction in patients with CKD.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:18Chronic Kidney Disease IV: Nursing Management
01:25Chronic Kidney Disease I: Introduction
01:28Diabetic Nephropathy
01:28Chronic Kidney Disease III: Interprofessional Care
01:22Heart Failure Drugs: Diuretics