Prevalence of Diastolic Dysfunction in Non‐Dialysis Dependent Chronic Kidney Disease Patients—Has the <scp>BSE</scp> 2024 Guidelines Shifted the Landscape?

ABSTRACT Diastolic dysfunction (DD) is a common precursor to many cardiovascular sequelae but is often difficult to assess in a chronic kidney disease (CKD) due to various factors. We aim to identify the prevalence of DD among CKD patients using British Society of Echocardiography guidelines (BSE 2024) and compare the prevalence to that using the American Society of Echocardiography guidelines (ASE 2016). We also aim to identify predictive factors for DD in a CKD cohort. A prospective, cross‐sectional study was conducted on screening patients with CKD Stage 3–5. Patients were stratified based on both ASE 2016 and BSE 2024, into two cohorts—(1) those with DD, and (2) those without. Univariate and multivariate logistic regression analysis (LRA) was performed to identify significant predictive factors for DD. A total of 152 patients were identified. Baseline characteristics were matched for both cohorts. The prevalence of DD using BSE 2024 was significantly lower when compared to prevalence estimation using ASE 2016 (54.6% vs. 66.4%; p &lt; 0.001), with many being relabelled as having normal diastolic function when implementing BSE 2024. LRA demonstrated that higher LV mass index (HR 1.07, 1.03–1.11; p &lt; 0.01), lower right ventricular 4‐chamber longitudinal strain (HR 0.83, 0.37–1.77; p = 0.036) and higher average E/e′ (HR 2.52, 1.21–5.28; p = 0.014) were predictive of DD. To our knowledge, our study is the first to delineate the prevalence of DD and its associated risk factors within a CKD population regionally. Our study highlights how BSE 2024 can potentially simplify and refine the diagnosis of DD in a CKD population.