Diastolic Dysfunction, an Underestimated New Challenge in Dialysis
Rachele Escoli1, Maria J Carvalho2, António Cabrita2
1Department of Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, Portugal.
Insights
Heart failure with preserved ejection fraction (HFpEF) is common in chronic kidney disease (CKD) patients, especially those on dialysis. This paper reviews HFpEF diagnosis, impact, and management in CKD.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) is highly prevalent in the general population and significantly more common in chronic kidney disease (CKD) patients.
- Heart failure with preserved ejection fraction (HFpEF) affects over half of dialysis patients, yet remains under-recognized and under-researched in CKD.
- Limited data exist on the clinical profiles and outcomes of HFpEF specifically within the CKD population.
Purpose of the Study:
- To critically appraise the current understanding of HFpEF diagnosis in CKD.
- To evaluate the clinical impact and management strategies for HFpEF in CKD patients.
- To focus on novel diagnostic criteria for HFpEF and their implications for dialysis patients.
Main Methods:
- Literature review and critical appraisal of existing studies.
- Analysis of diagnostic criteria for HFpEF.
- Examination of clinical data and outcomes in CKD and dialysis populations.
Main Results:
- HFpEF is a significant clinical challenge in CKD, particularly in dialysis patients.
- Existing diagnostic criteria for HFpEF may require adaptation for the CKD population.
- Further research is needed to elucidate the specific clinical profiles and optimize management of HFpEF in CKD.
Conclusions:
- HFpEF represents a substantial burden in CKD patients, necessitating improved recognition and research.
- New diagnostic approaches are crucial for accurate HFpEF identification in CKD.
- Understanding and addressing HFpEF is vital for improving outcomes in dialysis patients.
Abstract:
Heart failure (HF) is very common in the general population and specifically in CKD patients due to higher prevalence of traditional and CKD-related risk factors. In particular, HF with preserved ejection fraction (HFpEF) can affect over 50% of dialysis patients. However, little is known about this entity in CKD. It has been inadequately recognized over time and few data exist regarding clinical profiles and outcomes in dialysis patients. The aim of this paper is to do a critical appraisal of the diagnosis, clinical impact, and management of HFpEF with a focus on new diagnostic criteria and its impact on dialysis.
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