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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.9K

Fractional Flow Reserve Evaluation and Chronic Kidney Disease: Analysis From a Multicenter Italian Registry (the

Matteo Tebaldi1, Simone Biscaglia2, Massimo Fineschi3

  • 1Cardiovascular Institute, Azienda Ospedaliero-Universitaria Di Ferrara, Cona, Ferrara, Italy. tblmtt@unife.it.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 1, 2016
PubMed

Insights

Chronic kidney disease (CKD) may affect fractional flow reserve (FFR) measurements in patients with coronary stenosis. Flow-limiting FFR was less frequent in CKD patients, suggesting potential differences in microcirculation assessment.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Diagnostics

Background:

  • Fractional flow reserve (FFR)-guided revascularization improves outcomes in coronary artery disease.
  • Chronic kidney disease (CKD) is linked to impaired microcirculation and increased cardiovascular risk.
  • The impact of CKD on FFR accuracy remains unclear.

Purpose of the Study:

  • To determine if CKD influences FFR values in patients with intermediate coronary stenosis.
  • To investigate the relationship between CKD and FFR measurements.
  • To assess microcirculatory resistance (IMR) in relation to CKD.

Main Methods:

  • A multicenter prospective registry of 1,004 patients undergoing FFR evaluation.
  • CKD defined as creatinine clearance (CrCl) ≤45 ml/min.
  • IMR calculated in a substudy of 20 patients stratified by CrCl.

Main Results:

  • Patients with CKD (CrCl ≤45 ml/min) had significantly higher FFR values (0.84±0.07 vs. 0.81±0.08, p<0.001).
  • Positive FFR was less common in CKD patients (27% vs. 41%, p<0.01).
  • CKD (CrCl ≤45 ml/min) was an independent predictor of FFR measurement (HR 0.92, p=0.005), and IMR was higher in CKD patients (32 U vs. 16 U, p<0.01).

Conclusions:

  • FFR and IMR measurements differ between CKD patients and those with normal renal function.
  • Flow-limiting FFR is less frequent in patients with CrCl ≤45 ml/min.
  • CKD status should be considered when interpreting FFR and IMR in intermediate coronary stenosis.
Abstract

Keywords:
coronary artery diseasemicrovascular functionrenal failure

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