883 BLOOD PRESSURE, FLUID VOLUME, VASCULAR AND VENTRICULAR FUNCTION IN CHRONIC KIDNEY DISEASE

Background: Hypertension (HT) is an early feature of renal disease, and is highly prevalent in patients with chronic kidney disease (CKD) of any stage. HT increases the risk of loss of residual renal function and is associated with increased cardiovascular morbidity and mortality in CKD patients. Fluid retention due to CKD is commonly attributed as a pathogenic cause of hypertension in this population. The aim of this study was to investigate relationships between fluid volume, vascular and ventricular function in different CKD stages. Methods: Patients with essential hypertension (EHT, n = 17), CKD stages 3b-5 (CKD, n = 53), renal transplantation (Tx, n = 31) and peritoneal dialysis (PD, n = 21) underwent ambulatory blood pressure monitoring, augmentation index (AI), cardiac echocardiogram and total body water (TBW) measurement. Results: There was no difference in medication use between groups. 24 hour average diastolic pressure was lower in CKD than EHT, PD and Tx (68 ± 1 vs 76 ± 3* vs 75 ± 3* vs 75 ± 2*mmHg, *p’ < 0.05). AI was lower in Tx than EHT and CKD (17 ± 2 vs 25 ± 2* vs 30 ± 3*, *p’ < 0.05) but not PD (19 ± 3). TBW was higher in CKD than Tx and PD (34 ± 2 vs 15 ± 3* vs 14 ± 4*L, *p’ < 0.05) but not EHT (27 ± 4L, NS). Left ventricular diastolic dysfunction (LVDD) was less prevalent in EHT than CKD, Tx and PD (33% vs 75%* vs 58%* vs 89%*, *p < 0.005) Conclusions: CKD is accompanied by an increase in TBW, AI and LVDD, even when blood pressure is well-controlled. TBW and AI may be reduced by Tx and PD, however, there is persisting LVDD.