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


Journal

Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 12 04 2018
revised: 26 06 2018
accepted: 02 07 2018
pubmed: 12 7 2018
medline: 18 12 2019
entrez: 12 7 2018
Statut: ppublish

Résumé

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. 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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 29992694
doi: 10.1111/imj.14037
doi:

Substances chimiques

Biomarkers 0
Interleukin-18 0
Interleukin-12 187348-17-0
C-Reactive Protein 9007-41-4

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

240-247

Subventions

Organisme : Hollywood Private Hospital Research Foundation
ID : 303151, 1136046, RF026
Organisme : National Health and Medical Research Council
ID : GNT1039149, 303151, 1136046
Organisme : Pfizer CVL
Organisme : National Health & Medical Research Council Post-Graduate Scholarship
Organisme : Jacquot Research Entry Scholarship
Organisme : Jacquot Research Establishment Award

Informations de copyright

© 2018 Royal Australasian College of Physicians.

Auteurs

Kenneth Yong (K)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Department of Nephrology, Prince of Wales Hospital, Sydney, New South Wales, Australia.

Trevor Mori (T)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.

Gerard Chew (G)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.

Lawrence J Beilin (LJ)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.

Ian Puddey (I)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.

Gerald Watts (G)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.

Gursharan Dogra (G)

Department of Nephrology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Neil Boudville (N)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Department of Nephrology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Wai Lim (W)

School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Department of Nephrology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

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Classifications MeSH