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Updated: Jun 25, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Factors associated with risk analysis for asymptomatic left ventricular diastolic dysfunction in nondialysis patients
Yajuan Gao1, Shengnan Chen1, Jiani Fu1
1Department of Nephrology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Insights
Over 92% of patients with chronic kidney disease (CKD) have asymptomatic left ventricular diastolic dysfunction (ALVDD). Age, diabetic nephropathy, hypertension, CKD stage, blood pressure, urinary protein, and low calcium are key risk factors for ALVDD.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) is a significant predictor of outcomes in chronic kidney disease (CKD) patients.
- Left ventricular diastolic dysfunction (LVDD) is a common cause of HF with preserved ejection fraction (HFpEF) in CKD.
- Identifying risk factors for LVDD is crucial for managing cardiovascular disease (CVD) in CKD.
Purpose of the Study:
- To determine the prevalence of asymptomatic left ventricular diastolic dysfunction (ALVDD) in nondialysis CKD patients.
- To identify clinical and demographic factors associated with ALVDD in this population.
Main Methods:
- Retrospective cross-sectional study involving 339 nondialysis CKD patients.
- Collection of clinical and echocardiographic data.
- Multivariate logistic regression analysis to identify risk factors for ALVDD.
Main Results:
- A high prevalence of ALVDD (92.04%) was observed in the study cohort.
- Factors associated with increased risk for ALVDD include older age, diabetic nephropathy, hypertensive nephropathy, advanced CKD stage, elevated mean arterial pressure, and increased urinary protein.
- Low blood calcium was associated with a reduced risk of ALVDD.
Conclusions:
- Asymptomatic left ventricular diastolic dysfunction is highly prevalent in nondialysis CKD patients.
- Close monitoring and management of age, hypertension, diabetes, CKD progression, proteinuria, and calcium levels are essential.
- Early detection and intervention for ALVDD may help prevent progression to symptomatic HF and improve cardiovascular outcomes in CKD patients.
Abstract:
Heart failure (HF) constitutes a major determinant of outcome in chronic kidney disease (CKD) patients. The main pattern of HF in CKD patients is preserved ejection fraction (HFpEF), and left ventricular diastolic dysfunction (LVDD) is a frequent pathophysiological mechanism and specific preclinical manifestation of HFpEF. Therefore, exploring and intervention of the factors associated with risk for LVDD is of great importance in reducing the morbidity and mortality of cardiovascular disease (CVD) complications in CKD patients. We designed this retrospective cross-sectional study to collect clinical and echocardiographic data from 339 nondialysis CKD patients without obvious symptoms of HF to analyze the proportion of asymptomatic left ventricular diastolic dysfunction (ALVDD) and its related factors associated with risk by multivariate logistic regression analysis. Among the 339 nondialysis CKD patients, 92.04% had ALVDD. With the progression of CKD stage, the proportion of ALVDD gradually increased. The multivariate logistic regression analysis revealed that increased age (OR 1.237; 95% confidence interval (CI) 1.108-1.381, per year), diabetic nephropathy (DN) and hypertensive nephropathy (HTN) (OR 25.000; 95% CI 1.355-48.645, DN and HTN vs chronic interstitial nephritis), progression of CKD stage (OR 2.785; 95% CI 1.228-6.315, per stage), increased mean arterial pressure (OR 1.154; 95% CI 1.051-1.268, per mmHg), increased urinary protein (OR 2.825; 95% CI 1.484-5.405, per g/24 h), and low blood calcium (OR 0.072; 95% CI 0.006-0.859, per mmol/L) were factors associated with risk for ALVDD in nondialysis CKD patients after adjusting for other confounding factors. Therefore, dynamic monitoring of these factors associated with risk, timely diagnosis and treatment of ALVDD can delay the progression to symptomatic HF, which is of great importance for reducing CVD mortality, and improving the prognosis and quality of life in CKD patients.
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