Hyperphosphatemia May Predict Diastolic Dysfunction in CKD

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CKD patients with and without diastolic dysfunction had average serum phosphate levels of 7.3 and 5.5 mg/dL, respectively.
CKD patients with and without diastolic dysfunction had average serum phosphate levels of 7.3 and 5.5 mg/dL, respectively.

Hyperphosphatemia and high calcium-phosphorus product, but not low vitamin D levels, are associated with an increased likelihood of diastolic dysfunction among patients with chronic kidney disease (CKD) not on dialysis, new findings suggest.

Satyendra Kumar Sonkar, MD, of King George's Medical University in India, and collaborators assessed whether parameters of CKD mineral bone disorder (MBD) could predict diastolic dysfunction and left ventricular mass (LVM). Doppler echocardiography, tissue Doppler imaging, and M-mode echocardiography were performed on 86 non-diabetic patients with stage 4–5 CKD patients aged 18–40 years and 40 healthy controls matched by age and sex. None of the patients had pre-existing heart failure or previous acute coronary events. Patients with severe anemia or who used erythropoiesis-stimulating agents were excluded.

According to results published in the Saudi Journal of Kidney Diseases and Transplantation (2017;28:758-763) 48.8% of the CKD patients had diastolic dysfunction compared with none of the controls. Diastolic dysfunction was significantly associated with serum phosphorus and calcium-phosphorus product above 55 mg2/dL2. CKD patients with and without diastolic dysfunction had average serum phosphate of 7.3 and 5.5 mg/dL, respectively.

Although vitamin D levels were significantly lower among the CKD patients, the investigators found no significant association between vitamin D deficiency and diastolic dysfunction in these patients.

 

Reference

Kumar Sonkar S, Bhutani M, Kumar Sonkar G, et al. Vitamin D levels and other biochemical parameters of mineral bone disorders and their association with diastolic dysfunction and left ventricular mass in young nondiabetic adult patients with chronic kidney disease. Saudi J Kidney Dis Transpl 2017;28(4):758-763.

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