Lower kidney function was consistently associated with a more adverse diastolic echocardiographic phenotype, characterized by higher filling pressures, greater structural remodeling, and increased hemodynamic burden, which was already established at initial clinical assessment and did not show measurable further divergence on serial routine echocardiograms.
Declining eGFR was significantly associated with increased E/e' ratio across the study population.
Declining eGFR was significantly associated with increased left atrial volume index.
Declining eGFR was significantly associated with increased tricuspid regurgitation velocity.
Declining eGFR was significantly associated with increased left ventricular mass index.
The interaction between time and eGFR was not statistically significant for any of the diastolic dysfunction parameters.
Patients with lower eGFR had a higher prevalence of hypertension and diabetes at baseline.
The study population consisted of 1812 outpatients who underwent at least two echocardiographic assessments and had a measurement of kidney function.
This research suggests that patients with worse kidney function tend to have a more abnormal heart structure and function — specifically, signs of the heart having to work harder to fill properly (a condition called diastolic dysfunction). Using data from nearly 1,800 patients who had at least two heart ultrasounds (echocardiograms) over time, the researchers found that lower kidney function was linked to higher pressures inside the heart, a larger left atrial chamber, thicker heart muscle, and increased strain on the right side of the heart — all markers of diastolic dysfunction. Importantly, this research suggests that the connection between kidney disease and heart dysfunction was not something that gradually developed or worsened over the period of follow-up captured in routine clinical echocardiograms. Instead, the worse heart profile in patients with lower kidney function appeared to already be present at the time of their first echocardiogram, and the gap between patients with better and worse kidney function did not widen further over time based on serial testing. This has practical implications for how clinicians might approach patients with chronic kidney disease. It suggests that the cardiac damage associated with kidney disease may occur early — possibly before patients are even referred for echocardiographic evaluation in a clinical setting — rather than accumulating progressively during routine monitoring. This underscores the potential importance of early cardiac assessment in patients with kidney disease, and may inform how future studies design follow-up strategies to detect cardiac changes in this population.
Porras C, Dal Canto E, Handoko M, Haitjema S, de Groot M, Bots M, et al.. (2026). Longitudinal Echocardiographic Parameters of Diastolic Dysfunction Are Influenced by Kidney Function: A Study in Routine Clinical Practice.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.046252