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Patients on maintenance haemodialysis (HD) have high cardiovascular mortality rate. Our aim was to determine the cardiovascular risk factors in maintenance HD patients.
One hundred four maintenance HD patients were enrolled. The left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left atrial diameter (LAd), left ventricular posterior wall thickness (LVPWT), and interventricular septal thickness (IVST) were measured. Patients’ clinical and dialysis data were collected. Kaplan-Meier survival analysis was used to evaluate the patients’ survival. Multiple regression analysis was performed to evaluate risk factors for left ventricular hypertrophy (LVH).
Results and Debates
The mean age of included patients was 57.04±10.16 years with male to female ratio of 1.88:1. Eighty four patients (80%) were found to have LVH. Multiple stepwise regression analysis showed that ultrafiltration (P=0.004, OR=0.307) and hemoglobin (P=0.001, OR=0.361) were independent risk factors for LVH. Higher left ventricular mass index, IVST, phosphorus, calcium-phosphorus product, parathyroid and ultrafiltration, but similar incidence of LVH (78.2% vs. 81.3%, P=0.098) were found in patients with HD 3 times a week compared to those twice a week. Multiple stepwise regression analysis showed that inadequate dialysis doses estimated as Kt/V was an independent risk factor for LVH (P=0.004, OR=0.541) in patients with HD twice a week, while hemoglobin was a risk factor (P=0.002, OR=0.488) in patients with HD 3 times a week. During the 36.43±15.78-month follow-up, the survival rates were 84% and 68.3% in patients without and with LVH, respectively. Kaplan-Meier survival analysis showed that the survival rates after 12, 24, 36, and 48 months were 93.0%, 88.9%, 73.8%, and 61.2%, respectively, in LVH patients. High incidence of LVH is found in maintenance haemodialysis patients. Several risk factors were found to be correlated with LVH. Prevention of LVH may improve the prognosis of haemodialysis patients.