Correlation between volume overload, chronic inflammation, and left ventricular dysfunction in chronic kidney disease...

Area of Science:

• Nephrology
• Cardiology
• Inflammation Research

Background:

• Fluid overload is prevalent in chronic kidney disease (CKD), potentially exacerbating chronic inflammation and left ventricular dysfunction.
• Understanding the interplay between volume status, inflammation, and cardiac function is crucial for CKD patient management.

Purpose of the Study:

• To investigate the association between volume overload, chronic inflammation markers, and left ventricular dysfunction in CKD patients across different stages and dialysis modalities.
• To explore the specific impact of hemodialysis (HD) and peritoneal dialysis (PD) on these parameters.

Main Methods:

• A cohort of 160 participants including PD, HD, stage-3 CKD patients, and controls were assessed.
• Fluid status was measured using a body composition monitor (BCM).
• Serum markers of inflammation (endotoxin, LPS-binding protein [LBP], C-reactive protein [CRP], interleukin-6 [IL-6]) and echocardiography for left ventricular function were analyzed.

Main Results:

• Endotoxemia and volume overload were prevalent in CKD patients, worsening with reduced kidney function.
• Elevated endotoxin, IL-6, CRP, and LBP levels were observed in volume-overloaded patients compared to euvolemic individuals.
• Higher left ventricular mass index (LVMI) was associated with elevated endotoxemia; fluid overload correlated with endotoxin, IL-6, and LVMI.

Conclusions:

• CKD patients frequently exhibit significant endotoxemia and volume overload, contributing to chronic inflammation and left ventricular dysfunction.
• Hemodialysis treatment may exacerbate endotoxemia, potentially worsening cardiac complications in HD patients.