The relationship between pulse pressure and inflammation with left ventricular diastolic dysfunction in chronic kidney disease patients.

INTRODUCTION: 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-hour pulse pressure (PP)] with DD in stage 3-4 CKD patients.

METHODS: We performed a sub-analysis of 78 non-diabetic stage 3-4 CKD subjects to determine the relationship between 24-hour 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±2.0years; p<0.001) and had higher 24-hour PP [48(95%CI 45, 52) vs 43(95%CI 41, 45)mmHg; p<0.005]. 24-hour 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 stage 3-4 CKD patients but was not associated with IL-12, IL-18 or hsCRP. The association between 24-hour 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. This article is protected by copyright. All rights reserved.