Left Ventricular Diastolic Dysfunction in End-Stage Kidney Disease: Pathogenesis, Diagnosis, and Treatment

Area of Science:

• Nephrology
• Cardiology
• Heart Failure Research

Background:

• Diastolic dysfunction is common in end-stage kidney disease (ESKD).
• ESKD patients possess numerous heart failure (HF) risk factors like hypertension, diabetes, and coronary artery disease.
• HF with preserved ejection fraction (diastolic HF) is increasingly recognized in hemodialysis patients.

Purpose of the Study:

• To review the pathogenesis, diagnosis, and potential treatment strategies for diastolic dysfunction and diastolic HF.
• To synthesize evidence from the general population applicable to ESKD patients.

Main Methods:

• Literature review of existing studies on diastolic dysfunction and diastolic HF.
• Analysis of evidence potentially applicable to end-stage kidney disease patients.

Main Results:

• Diastolic HF is prevalent in ESKD and associated with significant mortality.
• HF with preserved ejection fraction appears more common than HF with reduced ejection fraction in hemodialysis patients.

Conclusions:

• Diastolic dysfunction significantly impacts ESKD patients, predicting mortality.
• Further research is needed to adapt general population findings for effective ESKD diastolic HF management.