Chronic Kidney Disease Parameters Research Articles

Assessment of some biochemical parameters in chronic kidney disease (CKD) patients attending Usmanu Danfodiyo University Teaching Hospital, Sokoto

In chronic kidney disease (CKD), inadequate and poor nutrition are important factors affecting the outcome and recovery from disease and injury. This study was designed to assess some nutritional indices of patients with CKD attending UDUTH Sokoto. Seventy-five CKD patients and twenty-five controls were recruited, parameters such as serum albumin, total protein, haemoglobin, vitamin D, zinc and copper were determined using standard methods. A significant (P<0.05) increase in Urea, Creatinine, Uric acid, phosphate, copper and potassium was observed in the patients as compared to the controls. There was a significant (P< 0.05) decrease in sodium, chloride, calcium, bicarbonate and albumin of the patients when compared to the control. However, there was no significant difference (p>0.05) observed in the total protein levels of the patients and the control. Therefore, these assessed parameters plays important role for the screening of malnutrition in CKD patents and if this is established, nutritional intervention can be made to these patients to minimize or prevent the advances of malnutrition problems in the CKD patients.

Association between faecal microbiota and nutritional parameters in chronic kidney disease and healthy patients

Association between faecal microbiota and nutritional parameters in chronic kidney disease and healthy patients

The effects and safety of high dose vitamin D3 in hemodialysis patients.

Different studies have shown that hemodialysis patients require higher doses of Vitamin D3 (VD3) than the general population to achieve satisfactory replenishment. This study aims to assess the safety of such practice and its benefits on some of the parameters of Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD). A single-center clinical trial assessing the benefits of high dose VD3 in hemodialysis patients. The dose of VD3 (300,000 IU) was administered orally and monthly from April to December 2020 (9 months) at the dialysis unit. The data analyzed were blood levels of calcium, phosphorus, alkaline phosphatase, 25(OH)D, 1,25(OH)2D and intact parathyroid hormone (iPTH) done every three months. We could recruit a cohort of 23 patients. Blood levels of 25(OH)D increased significantly in 82.6% of the patients to above 30 ng/ml. A similar effect was observed with 1, 25(OH)2D levels. iPTH levels decreased significantly when levels of 25(OH)D exceeded 30ng/ml at the end of the nine months. Vitamin D serum levels were typically measured immediately before the next monthly dose was administered. Blood levels of calcium, phosphorus, and alkaline phosphatase were stable during the study period. No events of hypercalcemia were reported, and no patient discontinued the monthly VD3 supplementation. Monthly administration of a high dose of VD3 over a long period of nine months in hemodialysis patients was found to be safe and beneficial in VD3 replenishment. It also allowed a significant decrease in iPTH levels. Further studies are warranted to identify the therapeutic target level of 25(OH)D in hemodialysis patients, allowing beneficial effects on iPTH.

Serum irisin levels and osteoporosis in patients with advanced chronic kidney disease and renal transplant recipients

AimTo elucidate the association of serum irisin levels with bone mineral density (BMD) and calcium–phosphorus metabolism parameters in chronic kidney disease (CKD) patients and renal transplant recipients (RTRs).MethodsThis is a cross-sectional study involving CKD patients and RTRs. Healthy volunteers served as controls. Age, gender, and dialysis vintage were recorded. Serum irisin, creatinine, glucose, calcium, albumin, 25(OH) vitamin D, ferritin, C-reactive protein, A1C, and lipid profile were studied in all participants. Estimated glomerular filtration rate (eGFR), corrected calcium, and body mass index (BMI) were calculated.ResultsOverall, 49 patients (23 hemodialysis, 26 RTRs) and 25 control subjects were included. In hemodialysis (HD) group, 8 patients (34.8%) had osteoporosis, and 12 patients (52.2%) had osteopenia. In RTR group, 3 patients (11.5%) had osteoporosis, while 15 patients (57.7%) had osteopenia. Among controls, one had osteoporosis, and 7 had osteopenia. There was no significant difference between HD and RTRs; however, osteoporosis rate was significantly lower in control subjects. BMD measurements (femur and lumbar T- and Z-scores) were comparable between HD and RTR groups. Control group DEXA values were similar to RTRs; however, they were significantly higher compared to HD group. 25(OH) vitamin D levels were comparable between the HD and RTR groups, and these were significantly lower compared to values of the control group. Mean serum irisin level was 426.6 ± 191.2 pg/mL in hemodialysis group, 342.6 ± 174.8 in the RTR group, and 208.0 ± 186.1 in controls. Serum irisin levels were similar in RTR and HD groups, but their values were significantly higher compared to controls. When we compared serum irisin levels between patients with and without osteoporosis in the whole cohort and hemodialysis and RTR groups, there was no difference. Serum irisin was positively correlated with lumbar T-score both in hemodialysis and RTR groups.ConclusionOur study is the first in the literature revealing the positive correlation of serum irisin level with femur T-score in RTRs. Serum irisin level was also positively correlated with femur T-scores in hemodialysis patients.

A Comparative Study of Serum Phosphate and Related Parameters in Chronic Kidney Disease between the USA and Japan

Introduction: Recent studies have suggested a higher incidence of cardiovascular disease (CVD) among patients with chronic kidney disease (CKD) in the USA than in Japan. Hyperphosphatemia, a possible risk for CVD, may explain this difference; however, international differences in phosphate parameters in CKD have not been well elaborated. Methods: By using the baseline data from the USA and the Japanese nation-wide, multicenter, CKD cohort studies; the Chronic Renal Insufficiency Cohort Study (CRIC, N = 3,870) and the Chronic Kidney Disease-Japan Cohort Study (CKD-JAC, N = 2,632), we harmonized the measures and compared clinical parameters regarding phosphate metabolism or serum phosphate, fibroblast growth factor-23 (FGF23), and parathyroid hormone (PTH), in the cross-sectional model. Results: Multivariable linear regression analyses revealed that serum phosphate levels were significantly higher in CRIC across all levels of estimated glomerular filtration rate (eGFR) with the greatest difference being observed at lower levels of eGFR. Serum FGF23 and 25-hydroxy vitamin D (25OHD) levels were higher in CRIC, while PTH levels were higher in CKD-JAC at all levels of eGFR. Adjustments for demographics, 25OHD, medications, dietary intake or urinary excretion of phosphate, PTH, and FGF23 did not eliminate the difference in serum phosphate levels between the cohorts (0.43, 0.46, 0.54, 0.64, and 0.78 mg/dL higher in CRIC within eGFR strata of >50, 41–50, 31–40, 21–30, and ≤20 mL/min/1.73 m², respectively). These findings were consistent when only Asian CRIC participants (N = 105) were included in the analysis. Conclusion: Serum phosphate levels in CRIC were significantly higher than those of CKD-JAC across all stages of CKD, which may shed light on the international variations in phosphate parameters and thus in cardiovascular risk among CKD patients. The key mechanisms for the substantial differences in phosphate parameters need to be elucidated.

A high neutrophil to lymphocyte ratio is associated with poor nutritional status in chronic kidney disease patients.

We aimed to investigate the relationship between the neutrophil to lymphocyte ratio (NLR) and nutritional parameters in chronic kidney disease (CKD) patients. In this cross-sectional study, 187 non-dialysis CKD patients were enrolled. Daily dietary energy intake (DEI) and daily dietary protein intake (DPI) were assessed by 3-d dietary records. Protein-energy wasting (PEW) was defined as Subjective Global Assessment (SGA) class B and C. Spearman correlation analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The median NLR was 2·51 (1·83, 3·83). Patients with CKD stage 5 had the highest NLR level. A total of 19·3 % (n 36) of patients suffered from PEW. The NLR was positively correlated with SGA and serum P, and the NLR was negatively correlated with BMI, waist and hip circumference, triceps skinfold thickness, mid-arm muscle circumference, DPI and Hb. Multivariate logistic regression analysis adjusted for DPI, DEI, serum creatinine, blood urea nitrogen, uric acid and Hb showed that a high NLR was an independent risk factor for PEW (OR = 1·393, 95 % CI 1·078, 1·800, P = 0·011). ROC analysis showed that an NLR ≥ 2·62 had the ability to identify PEW among CKD patients, with a sensitivity of 77·8 %, a specificity of 62·3 % and an AUC of 0·71 (95 % CI 0·63, 0·81, P < 0·001). The NLR was closely associated with nutritional status. NLR may be an indicator of PEW in CKD patients.

The Relationship between Serum Osteopontin level and Parameters of Chronic Kidney Disease – Mineral Bone Disease in Patients on Regular Hemodialysis

The Relationship between Serum Osteopontin level and Parameters of Chronic Kidney Disease – Mineral Bone Disease in Patients on Regular Hemodialysis

Correlation between Noncompliance Behavior and Biochemical Parameters of Chronic Kidney Disease Patients Undergoing Hemodialysis

Abstract Background and Objectives Compliance with dietary, fluid, and medication instructions is a critically significant factor for the health and well-being of patients undergoing hemodialysis for an extended period. The current study assessed the correlation between noncompliance behavior and biochemical parameters of chronic kidney disease (CKD) patients undergoing hemodialysis. The study's objectives were 1) to assess patients' noncompliance behavior using a questionnaire, 2) to determine the biochemical parameters of CKD patients having noncompliance behavior, and 3) to find the correlation between biological parameters and noncompliance behavior. Methods A cross-sectional study was conducted from July 12, 2018, to February 10, 2019. A purposive sampling technique was used to recruit the participants, and 100 participants were included in the study. The End-Stage Renal Disease–Adherence Questionnaire was used to assess the non-compliance behavior. Results Most dialysis patients (70%) were compliant with the therapeutic regime, while 30% failed to comply. The study revealed a significant positive correlation between noncompliance behavior and biochemical parameters of CKD patients undergoing hemodialysis (r = 0.578, p &lt; 0.05). Conclusion Noncompliance behavior is significantly correlated with the biochemical parameters among patients with CKD on dialysis. Optimal health is possible through fluid and dietary compliance in these patients. Hence, adherence behavior plays a significant role in the health and recovery of dialysis patients with CKD.

Parameters of Chronic Kidney Disease to Identify Outpatients at Increased Risk for COVID-19 Mortality: A Cohort Study of UK Biobank Participants

Parameters of Chronic Kidney Disease to Identify Outpatients at Increased Risk for COVID-19 Mortality: A Cohort Study of UK Biobank Participants

The Effect of Combination Therapy with Melatonin on the Enzymes of Glutathione System and the Level of Transforming Growth Factor- β1 in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease

Aim. The aim of the work was to assess the effect of combination therapy with melatonin on the clinical and biochemical parameters of chronic kidney disease (CKD) and type 2 diabetes mellitus (DM), the level of transforming growth factor-β1, lipid profile, activity of the glutathione antioxidant system enzymes and the activity of NADPH-generating enzymes in patients.Materials and methods. The study involved 60 people (19 men and 41 women, average age 65.6 ± 9.3 years) with chronic kidney disease associated with type 2 diabetes. The patients were divided into 2 groups. The first group of patients received basic treatment (n = 30, 8 men and 22 women, mean age 64.1 ± 7.9 years); the second group of participants (n = 30, 11 men and 19 women, mean age 69.0 ± 10.5 years) received 2 mg of melatonin in addition to the basic therapy. The control group consisted of 65 apparently healthy individuals (30 men and 35 women, average age 42.3±17.7 years) with normal indicators of general and biochemical blood tests. In the course of the work, the analysis of clinical and biochemical indicators and lipid profile in blood serum, the level of transforming growth factor-β1 by enzyme immunoassay, the activity of enzymes of the glutathione antioxidant system and NADPH-generating enzymes by the spectrophotometric method were carried out.Results. The use of melatonin additionally with basic treatment compared with standard therapy led to a decrease in proteinuria (p=0.010), hyperglycemia (p=0.019), urea concentration (p=0.043), glycated hemoglobin (p=0.045) and transforming growth factor-β1 levels (p=0.020) in patients with CKD. In addition, the use of this drug led to a changing of the lipid profile, and the activity of glutathione antioxidant system enzymes and NADPH-generating enzymes.Conclusion. The differences observed during the study were apparently caused by the action of melatonin, which has nephroprotective and hypoglycemic properties, the ability to neutralize reactive oxygen species and activate the antioxidant system functioning.

The effect of Ramadan fasting on clinical and laboratory parameters in chronic kidney disease patients underwent hemodialysis

Background: Despite getting relief from not fasting during Ramadan, some hemodialysis patients will ask questions about how fasting affects their health and whether they are allowed to fast. This study aims to determine the relationship between Ramadan fasting on clinical and laboratory parameters in chronic kidney disease (CKD) patients undergoing hemodialysis.

The relationship between inflammation and hematological parameters in chronic kidney disease

The relationship between inflammation and hematological parameters in chronic kidney disease

The effect of Ramadan fasting on clinical and laboratory parameters in chronic kidney disease patients underwent hemodialysis

Background: Despite getting relief from not fasting during Ramadan, some hemodialysis patients will ask questions about how fasting affects their health and whether they are allowed to fast. This study aims to determine the relationship between Ramadan fasting on clinical and laboratory parameters in chronic kidney disease (CKD) patients undergoing hemodialysis.

POS-252 SERUM PHOSPHATE IS ASSOCIATED WITH FERRITIN IN NON-DIALYSIS CHRONIC KIDNEY DISEASE

Since recent reports from the literature linked serum phosphate (PO4) and fibroblast growth factor 23 (FGF23) to anemia, and also FGF23 with low levels of ferritin and higher need for intravenous iron, the current cross-sectional study was aimed to investigate relationships between mineral metabolism and iron status parameters in chronic kidney disease (CKD) patients. Eigthy-seven adults with non-dialysis CKD [(61% males, 55% over 60 years-old, with CKD vintage 4 (95%CI 4.2 to 6) years, 46% in stage G3, 37% stage G4, and 17% stage G5] were prospectively selected from patients admitted in a single center nephrology unit. Patients with known causes of anemia, intravenous iron administration in the last month, malignancies, and active inflammatory and infectious diseases were excluded. None of the subjects were treated with erythropoiesis stimulating agents. Medical history (including data on medications), physical examination, plasma iron status (ferritin, transferrin, iron, transferrin saturation) and mineral metabolism (total calcium, PO4, intact parathyroid hormone, c-terminal FGF23, alkaline phosphatase) parameters, hemogram, serum albumin and C-reactive protein (CRP) were assessed. Data were expressed as median (95%CI) if not otherwise stated. Univariate correlations by Spearman method, and multivariate linear and logistic regression models were used for the statistical analysis. The median values of serum ferritin (Fer), transferrin saturation (TSAT), hemoglobin (Hb) and C-reactive protein were 223 (232 to 316) ng/mL, 21.3 (20.5 to 24.6) %, 12±2g/dL, and 3 (4.4 to 8.8) mg/L, respectively. The prevalence of anemia (defined as Hb<13g/dL in men and <12g/dL in women) was 51%, while absolute iron deficiency (ferritin<100ng/mL) was found in 15% and decreased iron availability (ferritin >100ng/mL and TSAT <20%) in 46%. Similar proportions of subjects treated with vitamin D or phosphate binders were encountered in subgroups defined by below/over median values for both Fer and TSAT. In bivariate analysis, Fer was negatively associated with glomerular filtration rate (rs=–0.27, p=0.01) and serum transferrin (rs=–0.34, p=0.001), while positively with serum phosphate (rs=0.35, p=0.001). The last two parameters remained independent predictors of Fer in a model of multiple linear regression which explained 15% of ferritin variation: Beta –0.002 (–0.002 to 0.000), p=0.03 for transferrin, and Beta 0.74 (0.16 to 1.33), p=0.01 for Log(PO4). In addition, Log(PO4) was independently associated with Fer above the median in the logistic regression model (Chi2 12, p=0.003). As regards TSAT, inverse univariate correlations were found with body mass index (BMI), CRP and transferrin (rs=–0.33, p=0.002, rs=–0.34, p=0.001, and rs=–0.33, p=0.002, respectively). In multivariate analysis (R2 21, p<0.001), the same variables were retained as independent predictors [Log(BMI) Beta –0.55 (–1.02 to –0.08), p=0.02, Log(CRP) Beta –0.034 (–0.063 to –0.004), p=0.02, and transferrin Beta –0.002 (–0.002 to –0.001), p<0.001]. Neither ferritin nor TSAT did correlate with other calcium-phosphate metabolism parameters. Mineral metabolism seemed to have limited correlations with iron status, assessed by currently used peripheral indices, as only serum phosphate independently predicted ferritin in this group of epoetin-näive, non-dialysis, CKD patients without overt inflammation.

Association of serum lncRNA H19 expression with inflammatory and oxidative stress markers and routine biochemical parameters in chronic kidney disease.

Chronic kidney disease (CKD) is a disorder that affects millions worldwide, and current treatment options aiming at inhibiting the progression of kidney damage are limited. Long noncoding RNA (lncRNA) H19 is one of the first explored lncRNAs and its deregulation is associated with renal pathologies, such as renal cell injury and nephrotic syndrome. However, there is still no research investigating the connection between serum lncRNA H19 expressions and clinical outcomes in CKD patients. Therefore, we investigated the relation of serum lncRNA H19 expressions with routine biochemical parameters, inflammatory cytokines, oxidative stress and mineralization markers in advanced CKD patients. lncRNA H19 serum levels from 56 CKD patients and 20 healthy controls were analyzed with reverse-transcription quantitative polymerase chain reaction method. Serum tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), and osteocalcin (OC) levels were measured with enzyme linked-immunosorbent assay. Total antioxidant status (TAS) and total oxidative status (TOS) levels were evaluated by the routine measurement method. We found that lncRNA H19 expressions were upregulated in patients with CKD compared to the controls. Furthermore, lncRNA H19 relative expression levels showed a negative relationship with glomerular filtration rate (GFR) while it was positively correlated with ferritin, phosphorus, parathyroid hormone, TNF-α, IL-6, OC, TAS and TOS levels. lncRNA H19 expressions were increased in CKD stage 3-5 and HD patients, and elevated lncRNA H19 expressions were associated with decreased glomerular filtration rate, inflammation, and mineralization markers in these patients.

Prospective Comparative Study of the Effects of Clonidine and Moxonidine as Add on Therapy in Patients of Chronic Kidney Disease with Hypertension in a Tertiary Carecenter

Objectives: To compare the effects of clonidine and moxonidine as add on therapy in patients of chronickidney disease with hypertension.Method: It is an observational study of duration of one year. Patient who fall under the diagnostic criteria ofchronic kidney disease with hypertension were selected randomly from those attending the routine medicineoutpatient department and medicine wardat S.N. Medical College and associated hospital.Result and Conclusion: Study shows a slightly greater reduction in various parameters of chronic kidneydisease like systolic BP, diastolic BP, pulse rate, blood urea, and serum creatinine with moxonidine groupthan clonidine group. But statistically there was no significant difference was found in both groups.

Spectrum of red blood cell parameters in chronic kidney disease in a tertiary care centre

Background: Chronic Kidney Disease (CKD) is an emerging public health problem worldwide. The increasing cost of healthcare, particularly in developing nations like India, is a social and economic burden. Slow but progressive deterioration in kidney function leads to numerous hematological and biochemical changes. The aim of the present study is to study various changes in red cell parameters that occur in the CKD patients. Materials and Method: 50 patients with CKD were included in this study. Age, gender, RBC count; hemoglobin (Hb); hematocrit; mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); MCH concentration (MCHC); and peripheral smears were studied. Results were analyzed using SPSS 20.0 version. Results: Of the 50 CKD patients on maintenance HD, the most common group sampled were male patients (72%) with the mean age of 54 (±15) years. The study revealed that Hemoglobin (Hb), Packed Cell Volume (PCV), Red Blood Cells (RBC) were low in CKD patients. The most common type of anemia was normocytic normochromic anemia, followed by dimorphic anemia. Fragmented RBCs and Spherocytes were 42% and 32% respectively. Conclusion: CKD is associated with different degrees of abnormality in hematological parameters that needs careful evaluation and management. From the CBC and peripheral smear findings the type of anemia, the degree of hemolysis can be analysed and the patients can be evaluated for the underlying cause and treated appropriately. The present study might help clinicians understand haematological profile and take necessary steps in the management.

Urinary excretion of electrolytes and their correlation with clinical parameters in chronic kidney disease

Introduction: With the increasing incidence of chronic renal disease on a global scale, it is important to document the chemical abnormalities that not only indicate deteriorating renal function, but also aggravate the clinical picture by causing sustained electrolyte imbalance, ultimately contributing to End Stage Renal Disease (ESRD).&#x0D; Objective: To investigate 24-hr urinary electrolytes excretion of non-dialysis patients presenting with history of chronic kidney disease (CKD) and correlate the biochemical abnormalities with clinical parameters.&#x0D; Materials &amp; Methods: A total of 100 patients with CKD were included in a private clinic setup from February 2017 to December 2019 to retrospectively analyze the relationship of 24-hr urinary electrolytes with clinical indicators in these subjects. Besides demographic data, biochemical indices of concern were obtained through standard laboratory techniques. The patients were then divided on the basis of results into four quartile groups. Descriptive data analysis was done through SPSS 22.0.&#x0D; Results: Nephropathic patients had low eGFR, albumin, hemoglobin, blood calcium as well as 24-hr urine calcium and had high body mass index (BMI), systolic blood pressure, diastolic blood pressure, blood creatinine, blood sodium and 24-hr urine sodium. According to quartiles of 24-hr urinary sodium; in the Q4 group, 24-hr urine protein, 24-hr urine potassium and 24-hr urine calcium were the highest while according to quartile of 24-hr urinary potassium; the Q3 group had the highest 24-hr urine protein. According to quartile of urinary calcium, Q4 group blood calcium, 24-hr urine sodium and 24-hr urine potassium was high. The results revealed a positive correlation of 24-hr urinary sodium and potassium with 24-hr urine protein and a negative correlation of 24⁃hr urinary calcium with 24-hr urine protein.&#x0D; Conclusion: The levels of urinary electrolytes in patients with CKD are associated with urinary protein. It is, therefore, recommended that the above-mentioned disease be treated in these patients for their proper management.&#x0D; Keywords: Urine Chemistry; Proteinuria; Renal Insufficiency, Chronic.

Evaluation of the Progressivity Parameters of Chronic Kidney Disease after Branched-Chain Amino Acid Supplementation in Children

Chronic Kidney Disease (CKD) is not an uncommon issuein children. Chronic kidney disease is the abnormality ofstructure or function of the kidney that occurs for more than three months. The presence of a longitudinal decline inGlomerulus Filtration Rate (GFR), proteinuria, and hypertension Are the characteristics of CKD. One of the recommendationsof nutritional supplementation as the prevention of CKD is by the administration of oral Branched-Chain Amino Acid (BCAA).To date, there has been no research to analyze the effects of the BCAA on children with stage 2-4CKD. This study aimed toanalyze the effect of BCAA in inhibiting the progressivity of stage 2-4 CKD in children and improving nutritional status.Astudy with randomized pre-post test controlled trial design was performed in the Outpatient Clinic of Pediatric Nephrologyin Dr. Soetomo Hospital with stage 2-4CKD. The subjects were divided into two groups, such as the BCAA and placebo, andwere monitored for eight weeks to be evaluated the GFR, albumin, proteinuria, blood pressure, and nutritional status.Sixteen children with stage 2-4 CKD dominated by 71.4% of male patients were enrolled in this study. The mean age was 12.5(SD 2.90) years. Approximately 50% (p=0.767) stage 2 chronic kidney, 50% (p=1.000) moderate malnutrition, and 64.28%(p=1.000) short stature were found, with nephrotic syndrome as the most common underlying cause of CKD (p=0.149). InBCAA group, decrease of GFR -5.08±7.13 (p=0.055), increase of serum albumin 0.20±0.23 (p=0.062), decrease of deltasystole -11.57±15.08 (p=0.565) and diastole -4.85±16.25 (p=0.708), weight loss -0.07±1.01 (p=0.828), an increase of height0.14±0.24 (p=0.771), and a decrease in BMI -0.03±0.74 (p=0.389) were reported. It was concluded that branched-chainamino acid (leucine, isoleucine, and valine) supplementation did not provide a significant effect to inhibit progressivity ofstage 2-4CKD in children and improvement of nutritional status.

Left ventricular stiffness in paediatric patients with end-stage kidney disease.

We tested the hypothesis that myocardial stiffness is altered in paediatric patients with end-stage kidney disease (ESKD) and explored its association with clinical parameters of chronic kidney disease (CKD). Thirty-five patients with ESKD (16 males) aged 17.5 ± 3years old, 18/35 of whom were receiving dialysis and 17 post kidney transplant, were studied. Left ventricular (LV) myocardial stiffness was determined by measurement of diastolic wall strain (DWS) and stiffness index (SI), while LV diastolic function was interrogated by pulsed-wave and tissue Doppler echocardiography. Compared with available literature data, both dialysis and transplanted patients had significantly lower DWS and greater SI, reduced transmitral early (E) to late diastolic velocity ratio and septal and lateral mitral annular early (e') diastolic velocities, and greater septal and lateral E/e' ratios (all p < 0.05). Multivariate analysis revealed that z score of diastolic blood pressure (β = 0.43, p = 0.004) and the duration of renal replacement therapy (β = 0.55, p < 0.001) were significant determinants of LV SI. Subgroup analysis in post-transplant patients showed z score of diastolic blood pressure (β = 0.54, p = 0.025) remained as a significant determinant of LV SI. Increased LV myocardial stiffness is evident in paediatric dialysis and transplanted patients with ESKD, and is associated with blood pressure and duration of renal replacement therapy.