What is the clinical evidence from this study?

Study design: Observational. Population: End-stage renal disease (ESRD) (n=323). Intervention: End-stage renal disease (ESRD) on hemodialysis vs. Healthy controls. Primary outcome: Aortic strain (%) (p=0.001).

What question did this study set out to answer?

The study evaluates aortic stiffness and cardiac function in ESRD patients using echocardiographic parameters.

April 28, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Echocardiographic assessment of aortic stiffness and cardiac function in end-stage renal disease patients undergoing hemodialysis

KLKannika LoguSRM Institute of Science and Technology KBK. BalakrishnanHindu Mission Hospital MSMelina SahayHindu Mission Hospital

Key Result

End-stage renal disease patients undergoing hemodialysis demonstrated significantly reduced aortic strain (14.42% vs 21.04%) and distensibility compared to controls, indicating impaired vascular compliance.

Key Points

The study evaluates aortic stiffness and cardiac function in ESRD patients using echocardiographic parameters.
Comparative observational study with 323 patients (173 ESRD and 150 controls)
Echocardiographic evaluations of aortic stiffness and cardiac function parameters were conducted
Patients were screened based on estimated glomerular filtration rate (eGFR)
ESRD patients showed significantly higher aortic stiffness (P=0.030) and reduced aortic strain and distensibility (P<0.000)
Cardiac function was compromised in ESRD patients with lower LVEF (P<0.000) and prolonged IVRT (P<0.000)
No significant differences in left atrial diameter, systolic aortic diameter, or E/A ratio were noted.

Study Design

Type

Observational (n=323)

Multicenter

Structured PICO

Does end-stage renal disease undergoing hemodialysis increase aortic stiffness and impair cardiac function compared to controls?

Population

323 individuals, comprising 173 end-stage renal disease (ESRD) patients undergoing hemodialysis and 150 controls. Patient group mean age 59.49 years, 60.1% male, 63.6% with diabetes mellitus, and 79.8% with hypertension.

Comparator

150 control individuals without ESRD (mean age 56.59 years, 40.0% male).

Outcome

Aortic stiffness (measured by aortic strain, aortic distensibility, and aortic stiffness index) and cardiac function (LVEF, IVRT, IVCT, ET, and TEI index) assessed via echocardiography.surrogate

ESRD patients on hemodialysis exhibit significantly increased aortic stiffness and impaired cardiac function on echocardiography, highlighting the need for routine cardiovascular assessment in this population.

Main Result

Absolute Event Rate: 14.42% vs 21.04%

p-value: p=0.001

Limitations

Relatively small sample size of 173 ESRD patients may affect generalizability
Focused solely on stage 5 ESRD rather than including patients from different CKD stages
Unaccounted factors such as medication use, inflammatory markers, and lifestyle variables may have influenced cardiovascular parameters
Lack of follow-up data limits the assessment of aortic stiffness progression and long-term impact

Abstract

Introduction: End-stage renal disease (ESRD) is strongly associated with increased cardiovascular morbidity and mortality, with aortic stiffness emerging as a key predictor of adverse outcomes. Echocardiographic assessment of aortic stiffness and cardiac function provides valuable insights into these vascular changes. However, limited research has explored the extent of aortic stiffness and its clinical implications in ESRD patients. This study aimed to assess aortic stiffness and cardiovascular function in ESRD patients using echocardiographic parameters, including aortic strain, distensibility, and stiffness index. Objectives: Our study aimed to evaluate aortic stiffness by measuring aortic strain, aortic distensibility, and the aortic stiffness index, as well as assess cardiac function using echocardiographic parameters—including left ventricular ejection fraction (LVEF), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), ejection time (ET), and TEI index—between ESRD patients and a control group to determine the extent of cardiovascular alterations associated with renal dysfunction. Patients and Methods: In this comparative observational study, a total of 323 patients were enrolled, comprising 173 ESRD patients and 150 controls. Echocardiographic assessments were conducted to evaluate aortic stiffness index, aortic strain, aortic distensibility, and cardiac function parameters such as LVEF, IVRT, IVCT, and TEI index. Patients were screened based on estimated glomerular filtration rate (eGFR) and underwent echocardiographic evaluation using the Mindray DC-60 machine by a single operator. Results: ESRD patients demonstrated significantly higher aortic stiffness (P=0.030) and reduced aortic strain and distensibility (P<0.000) compared to controls, indicating impaired vascular compliance. Additionally, ESRD patients had lower LVEF (P<0.000), prolonged IVRT (P<0.000), IVCT (P=0.009), and ET (P=0.001), reflecting compromised myocardial function. No significant differences were observed in left atrial diameter, systolic aortic diameter, or E/A ratio. Conclusion: Aortic stiffness is significantly increased in ESRD patients undergoing hemodialysis, correlating with impaired cardiac function and vascular remodeling. These findings highlight the importance of routine cardiovascular assessment in ESRD patients to improve risk stratification and clinical management. Further large-scale, longitudinal studies are needed to validate these findings and explore potential therapeutic strategies.

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