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Type: Journal article
Title: Diastolic function is a strong predictor of mortality in patients with chronic kidney disease
Author: Farshid, A.
Pathak, R.
Shadbolt, B.
Arnolda, L.
Talaulikar, G.
Citation: BMC Nephrology, 2013; 14(1):280-1-280-6
Publisher: BioMed Central
Issue Date: 2013
ISSN: 1471-2369
Statement of
Ahmad Farshid, Rajeev Pathak, Bruce Shadbolt, Leonard Arnolda, and Girish Talaulikar
Abstract: Background: Cardiovascular disease is a major cause of death in patients with stage 4–5 Chronic Kidney disease (CKD, eGFR < 30). There are only limited data on the risk factors predicting these complications in CKD patients. Our aim was to determine the role of clinical and echocardiographic parameters in predicting mortality and cardiovascular complications in CKD patients. Methods: We conducted a prospective observational cohort study of 153 CKD patients between 2007 and 2009. All patients underwent echocardiography at baseline and were followed for a mean of 2.6 years using regular clinic visits and review of files and hospital presentations to record the incidence of cardiovascular events and death. Results: Of 153 patients enrolled, 57 (37%) were on dialysis and 45 (78%) of these patients were on haemodialysis. An enlarged LV was present in 32% of patients and in 22% the LVEF was below 55%. LV mass index was increased in 75% of patients. Some degree of diastolic dysfunction was present in 85% of patients and 35% had grade 2 or higher diastolic dysfunction. During follow up 41 patients (27%) died, 15 (39%) from cardiovascular causes. Mortality was 24.0% in the non-dialysis patients versus 31.6% in patients on dialysis (p=ns). On multivariate analysis age >75 years, previous history of MI, diastolic dysfunction and detectable serum troponin T were significant independent predictor of mortality (P < 0.01). Conclusion: Patients with stage 4–5 CKD had a mortality rate of 27% over a mean follow up of 2.6 years. Age >75 years, history of MI, diastolic dysfunction and troponin T were independent predictors of mortality.
Keywords: Chronic kidney disease; Echocardiography; Diastolic function; Cardiovascular disease; Troponin T
Rights: © 2013 Farshid et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.1186/1471-2369-14-280
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