ArticleKidney international2018
Coronary flow reserve is predictive of the risk of cardiovascular death regardless of chronic kidney disease stage.
Article in Kidney international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers.
What it found
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Who cites it
53 citing papers in PubMed, 83 citations in OpenAlex.
- Combination Hydralazine and Isosorbide Dinitrate in Dialysis-Dependent ESRD (HIDE): A Randomized, Placebo-Controlled, Pilot Trial.Kidney360 · 2020Trial
- Trial
- Blunted heart rate response during dipyridamole stress SPECT is associated with cardiovascular outcomes in an all-comers cohort.BMC cardiovascular disorders · 2026Article
- Review
- PET-Derived Renal Perfusion Provides a Window Into Cardiorenal Risk Beyond Filtration.Circulation. Cardiovascular imaging · 2026Article
- Prognostic Significance of Noninvasive Simultaneous Renal and Cardiac Perfusion: Interrogating Mechanisms of Cardiovascular-Kidney Interactions.Circulation. Cardiovascular imaging · 2026Article
- Dialyzer characteristics are associated with differential effects on intradialytic microvascular tissue perfusion.Annals of medicine and surgery (2012) · 2026Article
- The REgistry of Flow and Perfusion Imaging for Artificial Intelligence with positron emission tomography (REFINE PET):Rationale and design.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Article
- The Association of Adropin with Asymptomatic Coronary Calcification in Patients in Early Stages of Chronic Kidney Disease.International journal of molecular sciences · 2025Article
- Relationship Between Epicardial Fat Volume and Coronary Microvascular Dysfunction.Circulation reports · 2025Article
- Endothelial dysfunction in chronic kidney disease: a clinical perspective.American journal of physiology. Heart and circulatory physiology · 2025Review
- Myocardial Perfusion Scintigraphy Provides Incremental Prognostic Value in Patients on the Kidney Transplant Waiting List.Clinical transplantation · 2025Observational
- Oxidative stress initiates hemodynamic change in CKD-induced heart disease.Basic research in cardiology · 2024Article
- Review
- Unravelling the Complexities of Myocardial Injury in Patients with Chronic Kidney Disease.Journal of atherosclerosis and thrombosis · 2024Article
- Comparative Effectiveness of PET and SPECT MPI for Predicting Cardiovascular Events After Kidney Transplant.Circulation. Cardiovascular imaging · 2024Article
- Future of Radionuclide Myocardial Perfusion Imaging: Transitioning from SPECT to PET.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2023Article
- Role of nuclear cardiology in diagnosis and risk stratification of coronary microvascular disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Coronary Microvascular Disease Assessed by 82-Rubidium Positron Emission Tomography Myocardial Perfusion Imaging Is Associated With Small Vessel Disease of the Kidney and Brain.Journal of the American Heart Association · 2023Article
- Changes in absolute flow, myocardial resistance and FFR after chronic total occlusion percutaneous coronary intervention.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Observational
Corrections and comments
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Authors and funding
12 authors at 1 institution in 2 countries.
Funding
Abstract
Microvascular rarefaction is found in experimental uremia, but data from patients with chronic kidney disease (CKD) are limited. We therefore quantified absolute myocardial blood flow and coronary flow reserve (the ratio of peak to resting flow) from myocardial perfusion positron emission tomography scans at a single institution. Individuals were classified into standard CKD categories based on the estimated glomerular filtration rate. Associations of coronary flow reserve with CKD stage and cardiovascular mortality were analyzed in models adjusted for cardiovascular risk factors. The coronary flow reserve was significantly associated with CKD stage, declining in early CKD, but it did not differ significantly among individuals with stage 4, 5, and dialysis-dependent CKD. Flow reserve with preserved kidney function was 2.01, 2.06 in stage 1 CKD, 1.91 in stage 2, 1.68 in stage 3, 1.54 in stage 4, 1.66 in stage 5, and 1.55 in dialysis-dependent CKD. Coronary flow reserve was significantly associated with cardiovascular mortality in adjusted models (hazard ratio 0.76, 95% confidence interval: 0.63-0.92 per tertile of coronary flow reserve) without evidence of effect modification by CKD. Thus, coronary flow reserve is strongly associated with cardiovascular risk regardless of CKD severity and is low in early stage CKD without further decrement in stage 5 or dialysis-dependent CKD. This suggests that CKD physiology rather than the effects of dialysis is the primary driver of microvascular disease. Our findings highlight the potential contribution of microvascular dysfunction to cardiovascular risk in CKD and the need to define mechanisms linking low coronary flow reserve to mortality.
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Registered trials
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