[Assessment of right ventricular function in patients with chronic kidney disease stage IV NKF]

Cardiovascular diseases are accountable for almost 50% of over-all mortality rates in chronic kidney disease (CKD) patients, especially in those who undergo hemo-dialysis or peritoneal dialysis.Hemodialysis patients present higher rates of pulmonary hypertension (PH), an independent risk factor for cardiovascular mortality among this patient population, due in part to the presence and hemodynamic effects of vascular access (both artero-venous fistula and central venous catheter). Echocardiographic TAPSE (tricuspid annular plane systolic excursion) index represents a helpful tool for investigation of right ventricular function together with PAPs (systolic pulmonary artery pressure) evaluation.The following study protocol, introduced by the Cardionephrology Study Group of the Italian Society of Nephrology, aims to evaluate the incidence of right ventricular dysfunction and PH in CKD patients. This is a multicentric, case- control study which includes two arms, each comprising 200 patients, and which will last 24-36 months.Glomerular filtration rates (GFR) are calculated using the eGFR EPI equation, while echocardiographic evaluation includes atrial and ventricular dimension and area, left ventricular systolic function (ejection fraction), diastolic function, TAPSE index measurement and PAPs evaluation.