Introduction:
Inflammation is a risk factor that affects the development and progression of chronic kidney disease (CKD) as well as its most serious complications - cardiovascular disease (CVD). The mortality of patients with CKD and CVD is increased compared to patients with CVD and normal kidney function. The aim of our study was to examine the association between inflammatory biomarkers and left ventricular diastolic dysfunction (LVD) in patients with CKD who did not start dialysis treatment.
Methods:
In a cross-sectional study, we analyzed 100 patients with CKD, stage I-V, who were divided into two groups based on glomerular filtration rate - GFR. The first group (G1) consisted of patients with CKD stage I, II (GFR ≥ 60 mL/min/1.73 m2), and the second group (G2) stage III, IV and V - who did not start dialysis treatment ( GFR >10 < 60 mL/min/1.73 m2). In addition to standard laboratory analyses, we determined inflammatory markers for all patients: ESR, fibrinogen, CRP, IL1, IL6, TNF-ɑ, malonyldialdehyde (MDA). We also determined the derived parameters IL6/albumin ratio (IAR) and fibrinogen/albumin ratio (FAR). All patients underwent echocardiography.
Results:
Analyzing inflammation parameters in relation to the stage of CKD, between groups G1 and G2, a statistically significant difference (p<0.001) was observed for ERS, CRP, MDA, TNF-ɑ, IL1, FAR and IAR, as well as for fibrinogen and IL6 ( p<0.05). By echocardiographic examination, DDLV was verified in 84% of patients with CKD, left ventricular systolic dysfunction (SLVD) in 14% and left ventricular hypertrophy in 28%. Fewer patients in the G2 group had normal diastolic function compared to G1 (p<0.05). In relation to DDLV, statistical significance was observed for: IAR and FAR (p<0.001), fibrinogen, IL6, MDA (p<0,05). In relation to SDLV, statistical significance was recorded for: FAR (p<0.001), ESR, CRP (p<0.05). Left ventricular hypertrophy was significantly correlated with: MDA (p<0.05). Also, the inflammation biomarker FAR was statistically significantly associated with both DDLK and SDLK, while IAR was only associated with DDLK.
Conclusions:
Investigated biomarkers of inflammation in our study are significantly associated with the progression of chronic kidney disease and left ventricular diastolic dysfunction. The most sensitive biomarker of inflammation in our patients was IAR. These results may provide useful prognostic information in CKD patients not treated with dialysis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.