Author:
Chisavu Lazar A.,Apostol Adrian,Pop Gheorghe N.,Ivan Viviana,Schiller Oana,Bob Flaviu,Marc Luciana,Mihaescu Adelina,Gadalean Florica,Grosu Iulia,Timar Bogdan,Schiller Adalbert
Abstract
AbstractLeft ventricular (LV) structure and function anomalies are frequent during the CKD continuum and are associated with increased risk of mortality. Cross section and longitudinal ultrasound data are available for advanced CKD and transition to ESKD. Less information is available about LV changes during stable, long-term hemodialysis (HD) treatment. All stable HD patients from 9 HD centers (1034 patients, 671 males, age 58.71 ± 12.94 years) have been enrolled in January 2015. The cohort was followed-up for 4 years, kidney transplantation or death. Yearly, two-dimensional and M-mode continuous and Pulse Doppler echocardiography were performed. During the follow-up, the prevalence of cardiovascular comorbidities significantly increased (p < 0.0001), coronary artery disease (CAD) from 73.5 to 88.8%, peripheral artery disease (PAD) from 29 to 40.9%, cerebral vascular disease (CVD) from 20.4 to 30.8%, heart valves calcification (VC) from 65.6 to 89.3% and left ventricular hypertrophy (LVH) from 67.6 to 76.5%. The mortality risk increased with the presence of CAD (1.59-fold), PAD (1.61-fold), CVD (1.59-fold), and VC (1.77-fold). Mortality risk was increased in those with LVEF < 50% (LVEF 40–49% 1.5-fold and LVEF < 40% 2.3 fold). Among the survivors of the first year, LVEF varied (> 5% decrease, > 5% increase and ± 5% variations). More than 5% increase of LVEF was associated with higher mortality risk (crude 1.5-fold, adjusted 1.43-fold) compared to stationary EF (p = 0.001). Cardiovascular disease progresses during stable long-term HD therapy and increases mortality risk. HF becomes highly prevalent but only HF with decreased LVEF < 50% is associated with increased risk of mortality.
Publisher
Springer Science and Business Media LLC
Reference32 articles.
1. United States Renal Data System. 2019 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States (National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2019).
2. Jager, K. J. et al. Cardiovascular and non-cardiovascular mortality in dialysis patients: Where is the link? Kidney Int. Suppl. 1, 21–23. https://doi.org/10.1038/kisup.2011.7 (2011).
3. Steenkamp, R., Rao, A. & Roderick, P. UK Renal Registry 17th annual report: Chapter 5 survival and cause of death in UK adult patients on renal replacement therapy in 2013: National and centre-specific analyses. Nephron 129, 99–129. https://doi.org/10.1159/000370275 (2015).
4. Neovius, M. et al. Mortality in chronic kidney disease and renal replacement therapy: A population-based cohort study. BMJ Open 4, e004251. https://doi.org/10.1136/bmjopen-2013-004251 (2014).
5. Wu, I. W. et al. Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease. J. Nephrol. 23, 181–188 (2010).
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