Premium
Relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients
Author(s) -
Yong Kenneth,
Mori Trevor,
Chew Gerard,
Beilin Lawrence J.,
Puddey Ian,
Watts Gerald,
Dogra Gursharan,
Boudville Neil,
Lim Wai
Publication year - 2019
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.14037
Subject(s) - medicine , kidney disease , asymptomatic , arterial stiffness , pulse pressure , subclinical infection , confidence interval , pulse wave velocity , cardiology , blood pressure , pathogenesis , gastroenterology , systemic inflammation , diastole , cohort , inflammation
Background Diastolic dysfunction (DD) is an important cause of cardiovascular disease (CVD) mortality in chronic kidney disease (CKD) patients. Non‐traditional risk factors, such as arterial stiffness and inflammation, are implicated in the pathogenesis of DD in CKD patients. Aim To determine the association between inflammatory markers (interleukin (IL)‐12, IL‐18, highly sensitive C‐reactive protein (hsCRP)) and non‐invasive markers of arterial stiffness (24‐h pulse pressure (PP)) with DD in stages 3–4 CKD patients. Methods We performed a sub‐analysis of 78 non‐diabetic stages 3–4 CKD subjects to determine the relationship between 24‐h PP, IL‐12, IL‐18 and hsCRP with DD. Results DD was present in 38 subjects (49%). Subjects with DD were significantly older (61.0 ± 1.9 vs 50.2 ± 2.0 years; P < 0.001) and had higher 24‐h PP (48(95% confidence interval 45, 52) vs 43(95% confidence interval 41, 45) mmHg; P < 0.005); 24‐h PP was associated with DD ( P = 0.02), but this was no longer significant after adjustment for age ( P = 0.31). Serum IL‐12, IL‐18 and hsCRP levels were not significantly different between subjects with or without DD. Conclusion Asymptomatic subclinical DD was present in 50% of a cohort of stages 3–4 CKD patients but was not associated with IL‐12, IL‐18 or hsCRP. The association between 24‐h PP and DD was no longer apparent following adjustment for age, but given the small sample size, our findings will need to be explored in larger‐sized cohorts of individuals with moderate‐stage CKD.