Echocardiographic Assessment of Right Ventricular Systolic Function in Patients with Chronic Renal Disease.

Background: While pulmonary hypertension (HTN) is more common in individuals with chronic renal disease, there is a dearth of information about the development of right ventricular failure. The purpose of this study was to evaluate RV systolic function using tissue Doppler and conventional echocardiography in individuals with chronic renal impairment.

Subjects and methods: One hundred participants of both sexes who were above the age of 18 years old were included in this study. They were divided into four equal groups: Groups 1 and 2 comprise individuals with chronic renal disease at Stages 4 and 5, respectively. Group 3 is end-stage renal disease on hemodialysis (HD). Group 4 is a control group consisting of healthy, age-matched, nonrenal subjects who are normotensive, nondiabetic, and do not have any other comorbid conditions.

Results: Right ventricular basal diameter was significantly higher in groups chronic kidney disease (CKD) V and HD than control. Right ventricle tricuspid annular plane systolic excursion (RV TAPSE) and RV tissue Doppler imaging(S') were significantly lower in CKD Group V than HD and control group. Pulmonary HTN is present in 22% of renal patients with significantly higher prevalence in HD group. There was a positive correlation between the estimated glomerular filtration rate (eGFR) and RV TAPSE and between eGFR and RV (S') of CKD IV and CKD V groups. There was a negative correlation between RV TAPSE and pulmonary arterial systolic pressure by echocardiogram of the studied groups. There was a positive correlation between RV TAPSE and RV (S') of the studied groups.

Conclusions: HD patients showed better RV systolic indices than CKD Stage 5 patients. Pulmonary HTN, although present in all stages of CKD, showed higher prevalence in HD patients.