Table 2

Summary of studies on coronary microvascular dysfunction in chronic kidney disease (CKD)

StudyYearCountryPopulationModalityFindings
Ragosta et al 18 2004USAControls (n=32)
Patients with diabetes with no kidney disease (n=11)
Patients with diabetic nephropathy (n=21)
Doppler angiographySignificantly lower CFR in patients with diabetic nephropathy compared with other two groups.
Tok et al 25 2005TurkeyControls (n=14)
Patients on HD (n=10)
Doppler TTESignificantly lower CFR in HD patients.
Chade et al 17 2006USAGFR >60 mL/min (n=481)
GFR <60 mL/min (n=124)
Doppler angiographyNon-significant trend towards reduced CFR as eGFR falls.
Viganò et al 26 2007ItalyControls (n=17)
Renal transplant recipients (n=25)
Doppler TTECFR impaired in half of cases.
Niizuma et al 24 2008JapanControls (n=20)
Patients on HD (n=21)
Doppler TTESignificantly lower CFR in HD patients.
Caliskan et al 12 2008TurkeyControls (n=39)
HD (n=48)
Renal transplant recipients (n=27)
Doppler TTESignificantly lower CFR in ESRD and in renal transplant recipients. Lower CFR in ESRD than renal transplant recipients.
Bezante et al 11 2009ItalyPatients with hypertension and normal renal function (n=64)
Patients with hypertension and renal impairment (n=12)
Doppler TTESignificantly lower CFR in patients with hypertension and renal impairment.
Koivuviita et al 20 2009FinlandControls (n=10)
CKD stages 3–5 (n=22)
PETNon-significant trend towards reduced CFR as eGFR falls.
Turiel et al 27 2009ItalyControls (n=25)
Renal transplant recipients (n=25)
Doppler TTESignificantly lower CFR in renal transplant recipients compared with controls.
Bozbas et al 13 2009TurkeyControls (n=26)
ESRD (n=30)
Renal transplant recipients (n=30)
Doppler TTESignificantly lower CFR in ESRD and in renal transplant recipients. Lower CFR in ESRD than renal transplant recipients.
Charytan et al 21 2010USACKD stages 1–3 (n=435)PETNon-significant trend towards reduced CFR as eGFR falls
Akagun et al 28 2011TurkeyRenal transplant recipients (n=20)Doppler TTECFR <2 in 65%
Murthy et al 29 2012USAeGFR <60 mL/min (n=866)PETCFR <1.5 associated with increased risk of cardiac mortality.
Imamura et al 23 2014JapanControls (n=15)
CKD stages 1–5 (n=175)
Doppler TTESignificant decrease in CFR as eGFR falls. Incremental reduction in CFR with albuminuria.
Shah et al 14 2016USADialysis-dependent patients (n=168)PETCFR <1.5 associated with increased risk of cardiac mortality.
Nakanishi et al 15 2013JapaneGFR <60 mL/min (n=139)Doppler TTECFR <2 associated with worse cardiovascular outcomes.
Tona et al 30 2016ItalySimultaneous kidney pancreas transplant recipients (n=48)Doppler TTELower CFR associated with worse cardiovascular outcomes.
Paz et al 16 2017USAESRD awaiting transplant (n=131)PETCFR <2 in 58.8% of patients with ESRD.
Charytan et al 22 2018USAControls (n=198)
CKD stages 1–5 (n=3748)
PETSignificant decrease in CFR as CKD stage increases.
Nelson et al 19 2019USAControls (n=15)
ESRD (n=15)
Doppler angiographySignificantly 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.