Left Ventricular Diastolic Dysfunction and Progression of Chronic Kidney Disease: Analysis of KNOW-CKD Data

Area of Science:

• Cardiology
• Nephrology
• Echocardiography

Background:

• Few studies have explored the relationship between the E/e' ratio and the progression of chronic kidney disease (CKD).
• The E/e' ratio, a measure of diastolic heart function, has not been extensively studied in the context of CKD progression.

Purpose of the Study:

• To investigate the association between the E/e' ratio and the risk of renal events in patients with nondialysis CKD.
• To determine if diastolic heart dysfunction, indicated by elevated E/e', is a predictor of CKD progression.

Main Methods:

• Retrospective analysis of data from 2238 patients with nondialysis CKD from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD).
• Renal events were defined as a >50% decrease in estimated glomerular filtration rate (eGFR), doubling of serum creatinine, or initiation of dialysis/kidney transplantation.
• Multivariable Cox proportional hazard regression and penalized spline curve analysis were used to assess the association between E/e' and renal events.

Main Results:

• During a mean follow-up of 59.1 months, 34.9% of patients experienced renal events.
• A 1-unit increase in E/e' was associated with a 2.7% increased hazard of renal events (Hazard Ratio: 1.027; 95% CI: 1.005-1.050; P=0.016).
• A suggested threshold for E/e' indicating increased renal event risk was identified as 12.

Conclusions:

• Increased E/e' is significantly associated with a higher risk of renal events in patients with nondialysis CKD.
• Diastolic heart dysfunction, as indicated by elevated E/e', may represent a novel risk factor for CKD progression.
• The E/e' ratio could serve as a valuable prognostic marker in managing patients with chronic kidney disease.