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Updated: Jul 4, 2025
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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Cardiac Magnetic Resonance Imaging Findings in Patients With Chronic Kidney Disease and End-Stage Kidney Disease: A
Deepak Chandramohan1, Rhoshini Rajasekaran2, Raghunandan Konda1
1Nephrology, University of Alabama at Birmingham, Birmingham, USA.
Cureus
|February 5, 2024
Summary
Cardiac magnetic resonance imaging (CMR) detects fibrotic changes in chronic kidney disease (CKD) and end-stage kidney disease (ESKD). T1 mapping reveals increased cardiac mass and fibrosis, aiding early cardiomyopathy detection.
Area of Science:
- Cardiology
- Nephrology
- Radiology
- Biomedical Engineering
Background:
- Uremic cardiomyopathy, characterized by myocardial fibrosis, is a significant complication in chronic kidney disease (CKD) and end-stage kidney disease (ESKD).
- Early detection of fibrotic changes is crucial for managing potential complications like arrhythmia and heart failure.
- Cardiac magnetic resonance imaging (CMR) offers a noninvasive method to assess cardiac remodeling and fibrosis.
Purpose of the Study:
- To systematically review and meta-analyze the utility of cardiac magnetic resonance imaging (CMR) in detecting fibrotic changes in patients with CKD and ESKD.
- To evaluate the association between CMR-derived parameters and the severity of uremic cardiomyopathy.
- To assess the role of T1 mapping in quantifying myocardial fibrosis in these patient populations.
Main Methods:
- A comprehensive systematic search of electronic databases was performed to identify relevant studies.
- Studies were categorized based on scanner field strength (1.5T or 3T).
- A random-effects model was employed for meta-analysis, calculating pooled means, confidence intervals, and standardized mean differences (SMD), with heterogeneity assessed using the I2 statistic.
Main Results:
- The meta-analysis included 20 studies with 642 CKD patients and 658 ESKD patients on dialysis.
- Both CKD and ESKD patients exhibited increased left ventricular mass index (LVMi) compared to controls (SMD 0.37 and 0.88, respectively).
- T1 mapping revealed elevated native septal T1 values in both CKD and ESKD patients compared to controls (SMD 1.099 and 1.12, respectively), indicating myocardial fibrosis.
Conclusions:
- Patients with CKD and ESKD, even with preserved left ventricular ejection fraction (LVEF), demonstrate increased left ventricular mass and myocardial fibrosis as indicated by higher LVMi and T1 values.
- T1 mapping is a valuable tool for the early detection of cardiomyopathy and risk stratification in CKD and ESKD patients.
- Further large-scale randomized trials are warranted to confirm these findings and investigate the long-term impact of dialysis on cardiac fibrosis.
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