Association between E/e´ ratio and fluid overload in patients with predialysis chronic kidney disease

Kim, Jae‐Seok; Yang, Jae-Won; Yoo, Jin Sae; Choi, Seung Ok; Han, Byoung-Geun

doi:10.1371/journal.pone.0184764

Cited by 27 publications

(34 citation statements)

References 31 publications

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“…Volume overload may be associated with diastolic dysfunction. 43 However, our data indicate that volume overload is not a feature of our AKI model given that AKI did not affect either mean arterial blood pressure or weight; indeed, a slight trend for decreased blood pressure was observed after AKI. Thus, changes in mean arterial blood pressure or volume status do not plausibly account for the changes in the cardiac metabolome or function.…”

Section: Mean Arterial Blood Pressure and Weightmentioning

confidence: 60%

Metabolomics assessment reveals oxidative stress and altered energy production in the heart after ischemic acute kidney injury in mice

Fox

Gil

Kirkbride-Romeo

et al. 2019

Kidney International

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Acute kidney injury (AKI) is a systemic disease associated with widespread effects on distant organs, including the heart. Normal cardiac function is dependent on constant ATP generation, and the preferred method of energy production is via oxidative phosphorylation. Following direct ischemic cardiac injury, the cardiac metabolome is characterized by inadequate oxidative phosphorylation, increased oxidative stress, and increased alternate energy utilization. We assessed the impact of ischemic AKI on the metabolomics profile in the heart. Ischemic AKI was induced by 22 minutes of renal pedicle clamping, and 124 metabolites were measured in the heart at 4 hours, 24 hours, and 7 days post-procedure. Forty-one percent of measured metabolites were affected, with the most prominent changes observed 24 hours post-AKI. The post-AKI cardiac metabolome was characterized by amino acid depletion, increased oxidative stress, and evidence of alternative energy production, including a shift to anaerobic forms of energy production. These metabolomic effects were associated with significant cardiac ATP depletion and with echocardiographic evidence of diastolic dysfunction. In the kidney, metabolomics analysis revealed shifts suggestive of energy depletion and oxidative stress, which were reflected systemically in the plasma. This is the first study to examine the cardiac metabolome after AKI, and demonstrates that effects of ischemic AKI on the heart are akin to the effects of direct ischemic cardiac injury.

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Section: Mean Arterial Blood Pressure and Weightmentioning

confidence: 60%

Metabolomics assessment reveals oxidative stress and altered energy production in the heart after ischemic acute kidney injury in mice

Fox

Gil

Kirkbride-Romeo

et al. 2019

Kidney International

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“…Fluid overload is one predictor of mortality in ESRD patients and is closely related to adverse cardiovascular outcomes [ 19 , 20 , 21 ]. The volume status may independently affect serum albumin.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Phase Angle in Non-Dialysis CKD Stage 5 and Peritoneal Dialysis Patients

et al. 2018

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Background: Fluid overload and protein-energy wasting (PEW) are common in patients with end-stage renal disease (ESRD) and lead to a poor prognosis. We aimed to evaluate the volume and nutritional status of ESRD patients and to determine the clinical significance of phase angle (PhA). Methods: This study was a cross-sectional comparison of bioimpedance spectroscopy (BIS) findings in patients with non-dialysis chronic kidney disease (CKD) stage 5 (CKD5-ND, N = 80) and age/sex-matched peritoneal dialysis patients (PD, N = 80). PEW was defined as a PhA less than 4.5°. Results: The PhA was found to be positively associated with a geriatric nutritional risk index (GNRI, r = 0.561, p < 0.001), lean tissue index (LTI, r = 0.473, p < 0.001), and albumin (r = 0.565, p < 0.001) while OH/ECW (r = −0.824, p < 0.001) showed an inverse correlation. The CKD5-ND group had more overhydration (p = 0.027). The PD group had significantly higher PhA (p = 0.023), GNRI (p = 0.005), hemoglobin (p < 0.001), and albumin (p = 0.003) than the CKD5-ND group. The cut-off values predicting PEW were found to be 3.55 g/dL for albumin, 94.9 for GNRI, and 12.95 kg/m2 for LTI in PD patients. Conclusions: This study demonstrated that PhA could be used as a marker to reflect nutritional status in patients with ESRD. Since BIS can inform both volume and nutritional status, regular monitoring will provide the basis for active correction of fluid overload and nutritional supplementation, which may improve outcomes in patients with ESRD.

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“…In contrast, e′ velocity reflects LV stiffness, independent of the patient's volume status. 21 This is particularly important since heart failure with preserved EF is the most prevalent form in ESRD, and diagnosing diastolic dysfunction by TA B L E 1 Validated transthoracic echocardiography (TTE) parameters in end-stage renal disease accurately measuring E/e′ ratio may facilitate early therapeutic intervention. In addition, given the high prevalence of valvular calcification in ESRD, it is important to remember that moderate-to-severe mitral annular calcification can affect the accuracy of e′ measurement, when assessing DD.…”

Section: Diastolic Dysfunction (Dd)mentioning

confidence: 99%

Multi‐modality cardiac imaging in advanced chronic kidney disease

Ureche

Sascău

Țăpoi³

et al. 2019

Echocardiography

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Cardiovascular disease (CVD) is the leading cause of death worldwide and is particularly frequent among those with severe renal impairment. Early diagnosis and therapeutic intervention may help alleviate the burden of cardiovascular complication within this population. In the last years, advances have been made toward developing noninvasive imaging techniques that could offer better insight into the cardiac involvement in end‐stage renal disease (ESRD). Conventional transthoracic echocardiography remains the first‐line investigation used to assess cardiac function, but encompassing in our daily practice, the newer approaches such as speckle‐tracking imaging, cardiac computed tomography, or cardiac magnetic resonance can guide us to a more comprehensive understanding of CVD in ESRD. Given that patients with chronic kidney disease may not present with typical CVD symptoms, the amount of information brought by newer imaging techniques is crucial for an accurate diagnosis, risk stratification, and further management. The purpose of this review is to briefly summarize the specific applications of standard cardiac imaging techniques in patients with ESRD and to offer insight into the novel imaging modalities, highlighting the newest research in this field. By doing so, we aim to identify the most important imaging predictors of clinical outcomes in this population.

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Association between E/e´ ratio and fluid overload in patients with predialysis chronic kidney disease

Cited by 27 publications

References 31 publications

Metabolomics assessment reveals oxidative stress and altered energy production in the heart after ischemic acute kidney injury in mice

Metabolomics assessment reveals oxidative stress and altered energy production in the heart after ischemic acute kidney injury in mice

Clinical Significance of Phase Angle in Non-Dialysis CKD Stage 5 and Peritoneal Dialysis Patients

Multi‐modality cardiac imaging in advanced chronic kidney disease

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