Diastolic function in several stages of chronic kidney disease in patients with autosomal dominant polycystic kidney disease: a tissue Doppler imaging study.
BACKGROUND
This study evaluates the prevalence of diastolic dysfunction (DD) in several stages of chronic kidney disease (CKD) in patients with autosomal dominant polycystic kidney disease (ADPKD).


METHODS
107 ADPKD patients performed echocardiographic and Doppler studies and a tissue Doppler imaging (TDI) study. Patients were divided in three groups: group 1, 57 patients with CKD stage I, group 2, 37 patients in stages II and III, and group 3, 13 patients with CKD stages IV and V (not on dialysis).


RESULTS
In transmitral Doppler, 1 patient in group 1 compared to 5 in group 2, and 4 in group 3 exhibited DD (p < 0.005); moreover, E/A ratio decreases progressively from group 1 to 3 (p < 0.0001). In TDI, DD was observed in 8 patients in group 1, 17 in group 2, and 8 in group 3 had DD (p < 0.001). Em velocity, the best TDI parameter for DD, correlated with age, renal function and blood pressure. When adjusted for age, increased left ventricular mass index and decreased renal function were independent risk factors of DD.


CONCLUSIONS
DD occurred progressively as renal function deteriorates in patients with ADPKD and this effect is independently related to age and blood pressure.
de Almeida
Edgar A F
EA
Serviço de Nefrologia e Transplantação Renal, Hospital de Santa Maria, Lisboa, Portugal. edealmeida@mail.telepac.pt <edealmeida@mail.telepac.pt>
de Oliveira
Eduardo I
EI
Lopes
José António
JA
Almeida
Ana G
AG
Lopes
Mário G
MG
Prata
M Martins
MM
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies