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Assessment of cardiac structure and function in kidney failure: understanding echocardiography and magnetic resonance imaging for the nephrologist

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Abstract

Cardiovascular disease is the leading cause of death in patients with kidney failure or on chronic dialysis. Patients on chronic dialysis have a 10- to 50-fold increased risk of sudden cardiac death compared to patients with normal kidney function. Adverse changes in cardiac structure and function may not manifest with clinical symptoms in patients with kidney failure and, therefore, pose a challenge in identifying cardiac dysfunction early. Fortunately, there are multi-modality cardiac imaging techniques available, including echocardiography and cardiac magnetic resonance imaging, that can help our understanding of the pathophysiology of cardiac dysfunction in kidney failure. This review describes the benefits and limitations of these two commonly available cardiac imaging modalities to assess cardiac structure and function, thereby aiding nephrologists in choosing the most appropriate investigative tool based on individual clinical circumstances. For the purposes of this review, cardiac imaging for detection of coronary artery disease has been omitted.

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Acknowledgements

DP is a recipient of the Royal Australasian College of Physicians Jacquot Research Entry Scholarship 2019–2020.

Funding

No financial sponsor was involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Metro South and Integrated Nephrology and Transplant Services, Logan Hospital, Armstrong Road & Loganlea Road, Meadowbrook, QLD, 4131, Australia

    Dharmenaan Palamuthusingam & Sudhir Wahi

  2. Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia

    Dharmenaan Palamuthusingam, David Wayne Johnson, Camel M. Hawley & Magid Fahim

  3. Cardiovascular Imaging Section, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Reza Reyaldeen

  4. Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia

    David Wayne Johnson, Camel M. Hawley & Magid Fahim

  5. Translational Research Institute, Brisbane, Australia

    David Wayne Johnson

  6. Centre for Health Services Research, University of Queensland, St Lucia, QLD, 4072, Australia

    Elaine M. Pascoe

  7. School of Medicine, Griffith University, Mount Gravatt, QLD, Australia

    Dharmenaan Palamuthusingam

Authors
  1. Dharmenaan Palamuthusingam
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  2. Reza Reyaldeen
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  3. David Wayne Johnson
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  4. Camel M. Hawley
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  6. Sudhir Wahi
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  7. Magid Fahim
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All authors contributed to the conception, design, analysis, interpretation, drafting, critical revision and final approval of this version to be published.

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Correspondence to Dharmenaan Palamuthusingam.

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Conflict of interest

The Better Evidence And Translation—Chronic Kidney Disease (BEAT-CKD) program is an independent collaborative research program funded by an Australian National Health and Medical Research Council (NHMRC) Program Grant (APP1092957) and supports research into kidney disease. DP is a recipient of the Royal Australasian College of Physicians Jacquot Research Entry Scholarship and has received speaking honoraria from the Australian Medical Forum. DJ is a current recipient of an Australian National Health and Medical Research Council Practitioner Fellowship. DJ has previously received consultancy fees, research grants, speaker’s honoraria and travel sponsorships from Baxter Healthcare and Fresenius Medical Care. CH has received funding from Janssen and GlaxoSmithKline to her institution for trial steering committee roles and research grant support to her institution from Shire, Baxter, Fresenius, and Otsuka and travel sponsorship from Otsuka.

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Palamuthusingam, D., Reyaldeen, R., Johnson, D.W. et al. Assessment of cardiac structure and function in kidney failure: understanding echocardiography and magnetic resonance imaging for the nephrologist. Int Urol Nephrol 53, 699–712 (2021). https://doi.org/10.1007/s11255-020-02610-y

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