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Xaplanteris et al1 reviewed physiological indicators via catheterization to know the level of coronary circulation. Among them, fractional flow reserve (FFR) value has been used for evaluating severity of coronary stenosis. As there was no information on the relationship between FFR and chronic kidney disease (CKD) in the article, I present some references.
Tebaldi et al2 evaluated the effect of CKD on FFR value in patients with intermediate coronary stenosis. CKD was defined as creatinine clearance value ≤45 ml/min, and FFR positive was defined as ≤0.80. Adjusted hazard ratios (HRs) (95% confidence intervals (CIs)) of diabetes and CKD for FFR positive were 1.07 (1.008-1.13) and 0.92 (0.87-0.97), respectively. In contrast, Mohandas et al3 reported a positive relationship between renal function and FFR. A standardized way of FFR measurements is important, and inconsistent results on the relationship between FFR and CKD would partly be explained by the procedure of measurement. Anyway, CKD information in relation to FFR value should be confirmed by further study.
References
Xaplanteris P, Barbato E, De Bruyne B. Catheter-based functional metrics of the coronary circulation. J Nucl Cardiol. 2016. doi:10.1007/s12350-016-0652-7.
Tebaldi M, Biscaglia S, Fineschi M, Manari A, Menozzi M, Secco GG, et al. Fractional flow reserve evaluation and chronic kidney disease: analysis from a multicenter Italian registry (the FREAK Study). Catheter Cardiovasc Interv 2016;88:555-62.
Mohandas R, Segal MS, Huo T, Handberg EM, Petersen JW, Johnson BD, et al. Renal function and coronary microvascular dysfunction in women with symptoms/signs of ischemia. PLoS One 2015;10:e0125374.
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This Letter to the Editor is in response to a Review Article with doi:10.1007/s12350-016-0652-7.
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Kawada, T. Fractional flow reserve as an indicator of coronary circulation with special reference to kidney function. J. Nucl. Cardiol. 24, 1458 (2017). https://doi.org/10.1007/s12350-017-0786-2
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DOI: https://doi.org/10.1007/s12350-017-0786-2