Table 2.
Summary of studies on coronary microvascular dysfunction in chronic kidney disease (CKD)
Study | Year | Country | Population | Modality | Findings |
Ragosta et al 18 | 2004 | USA | Controls (n=32) Patients with diabetes with no kidney disease (n=11) Patients with diabetic nephropathy (n=21) |
Doppler angiography | Significantly lower CFR in patients with diabetic nephropathy compared with other two groups. |
Tok et al 25 | 2005 | Turkey | Controls (n=14) Patients on HD (n=10) |
Doppler TTE | Significantly lower CFR in HD patients. |
Chade et al 17 | 2006 | USA | GFR >60 mL/min (n=481) GFR <60 mL/min (n=124) |
Doppler angiography | Non-significant trend towards reduced CFR as eGFR falls. |
Viganò et al 26 | 2007 | Italy | Controls (n=17) Renal transplant recipients (n=25) |
Doppler TTE | CFR impaired in half of cases. |
Niizuma et al 24 | 2008 | Japan | Controls (n=20) Patients on HD (n=21) |
Doppler TTE | Significantly lower CFR in HD patients. |
Caliskan et al 12 | 2008 | Turkey | Controls (n=39) HD (n=48) Renal transplant recipients (n=27) |
Doppler TTE | Significantly lower CFR in ESRD and in renal transplant recipients. Lower CFR in ESRD than renal transplant recipients. |
Bezante et al 11 | 2009 | Italy | Patients with hypertension and normal renal function (n=64) Patients with hypertension and renal impairment (n=12) |
Doppler TTE | Significantly lower CFR in patients with hypertension and renal impairment. |
Koivuviita et al 20 | 2009 | Finland | Controls (n=10) CKD stages 3–5 (n=22) |
PET | Non-significant trend towards reduced CFR as eGFR falls. |
Turiel et al 27 | 2009 | Italy | Controls (n=25) Renal transplant recipients (n=25) |
Doppler TTE | Significantly lower CFR in renal transplant recipients compared with controls. |
Bozbas et al 13 | 2009 | Turkey | Controls (n=26) ESRD (n=30) Renal transplant recipients (n=30) |
Doppler TTE | Significantly lower CFR in ESRD and in renal transplant recipients. Lower CFR in ESRD than renal transplant recipients. |
Charytan et al 21 | 2010 | USA | CKD stages 1–3 (n=435) | PET | Non-significant trend towards reduced CFR as eGFR falls |
Akagun et al 28 | 2011 | Turkey | Renal transplant recipients (n=20) | Doppler TTE | CFR <2 in 65% |
Murthy et al 29 | 2012 | USA | eGFR <60 mL/min (n=866) | PET | CFR <1.5 associated with increased risk of cardiac mortality. |
Imamura et al 23 | 2014 | Japan | Controls (n=15) CKD stages 1–5 (n=175) |
Doppler TTE | Significant decrease in CFR as eGFR falls. Incremental reduction in CFR with albuminuria. |
Shah et al 14 | 2016 | USA | Dialysis-dependent patients (n=168) | PET | CFR <1.5 associated with increased risk of cardiac mortality. |
Nakanishi et al 15 | 2013 | Japan | eGFR <60 mL/min (n=139) | Doppler TTE | CFR <2 associated with worse cardiovascular outcomes. |
Tona et al 30 | 2016 | Italy | Simultaneous kidney pancreas transplant recipients (n=48) | Doppler TTE | Lower CFR associated with worse cardiovascular outcomes. |
Paz et al 16 | 2017 | USA | ESRD awaiting transplant (n=131) | PET | CFR <2 in 58.8% of patients with ESRD. |
Charytan et al 22 | 2018 | USA | Controls (n=198) CKD stages 1–5 (n=3748) |
PET | Significant decrease in CFR as CKD stage increases. |
Nelson et al 19 | 2019 | USA | Controls (n=15) ESRD (n=15) |
Doppler angiography | Significantly reduced CFR in ESRD compared with controls. |
CFR, Coronary flow reserve; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; HD, haemodialysis; PET, positron emission tomography; TTE, transthoracic echocardiography.