Internal and Emergency Medicine

, Volume 14, Issue 6, pp 923–929 | Cite as

Is echocardiography mandatory for patients with chronic kidney disease?

  • Emilio NardiEmail author
  • Giuseppe Mulè
  • Chiara Nardi
  • Giulio Geraci
  • Antonina Giammanco
  • Riccardo Bentivegna
  • Maurizio Averna


This study aims at evaluating the prevalence of left ventricular diastolic dysfunction in a group of 319 hypertensive patients with stage 3b–4–5 chronic kidney disease (according to Kidney Disease Improving Global Outcomes classification), compared with 216 patients with essential hypertension and normal renal function. All patients underwent echocardiographic examination. Patients on stage 1–2–3a chronic kidney disease, dialysis treatment, or with previous manifestations of heart failure or other cardiovascular diseases were excluded. Patients with renal disease had significantly worse diastolic function (both considering trans-mitral flow and tissue Doppler imaging parameters). Diastolic dysfunction is found in 70.5% of the CKD group and in 41.6% of hypertensive patients (p < 0.0001). Multiple regression analysis shows an association between renal function and diastolic function (β 0.223; p < 0.0001), independent of potential confounders. Our study shows that diastolic dysfunction is highly prevalent in patients with advanced chronic kidney disease; we posit that in this population, the risk of diastolic heart failure is very high. We think that patients with a marked decrease of glomerular filtration rate (GFR) must be considered at high risk for diastolic heart failure and should have an echocardiographic examination performed, even if asymptomatic and in the absence of evident cardiovascular disease.


Chronic kidney disease Hypertension Heart failure Diastolic function 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Statement of human and animal rights

The article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Our study is retrospective and formal consent is not required.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE)Università degli Studi di PalermoPalermoItaly

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