Clustering of unconventional cardiovascular risk factors among Taiwanese hemodialysis patients
Related Experiment Videos
Shih-Yuan Hung1, Hung-Hsiang Liou, Luo-Ping Ger
1Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung County, Taiwan, ROC.
Insights
Cardiovascular disease (CAVD) is a major risk for hemodialysis (HD) patients. This study identified conventional and novel risk factors, including left ventricular hypertrophy, to better assess CAVD risk in HD populations.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Cardiovascular disease (CAVD) is the leading cause of mortality in chronic hemodialysis (HD) patients.
- Risk factors for CAVD in this population remain incompletely understood.
Purpose of the Study:
- To investigate the prevalence of CAVD (coronary heart disease, cerebrovascular disease, peripheral vascular disease) in chronic HD patients.
- To identify conventional and novel risk factors associated with CAVD in this cohort.
Main Methods:
- A multicenter cross-sectional survey was conducted involving 995 chronic HD patients from 12 centers in Taiwan.
- Data on 30 parameters were collected and analyzed using multivariate logistic regression.
Main Results:
- Prevalence rates for coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD) were 24.0%, 6.0%, and 5.3%, respectively.
- Old age and diabetes were significant conventional risk factors for CAVD.
- Novel correlates included low apolipoprotein A-I and creatinine (CHD), low uric acid (CVD), low hematocrit, and low diastolic blood pressure (PVD).
- Left ventricular hypertrophy was an independent correlate for all three subtypes of CAVD.
Conclusions:
- Assessing CAVD risk in HD patients requires considering both conventional and unconventional risk factors.
- Identifying novel correlates like left ventricular hypertrophy can improve risk stratification for cardiovascular events in hemodialysis patients.
Background:
Cardiovascular disease (CAVD) is the most common cause of mortality for chronic hemodialysis (HD) patients, yet the risk factors for the events have not been well established.
Methods:
We conducted a multicenter cross-sectional survey in 995 chronic HD patients recruited from 12 HD centers in Taiwan to investigate the prevalence of CAVD, including coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD), and related them to 30 different parameters.
Results:
The mean age of 995 patients (499 males/496 females) was 56.4 +/- 12.3 years, and average HD duration was 59.8 +/- 51.2 months. The prevalence rates of CHD, CVD, and PVD were 24.0, 6.0, and 5.3%, respectively. Results of our multivariate logistic regression analysis showed that out of the conventional CAVD risk factors, only old age and diabetes could be significantly associated with CAVD. Meanwhile, we found some novel clinical correlates, including low apolipoprotein A-I and creatinine for CHD, low uric acid for CVD, and low hematocrit and low diastolic blood pressure for PVD. Interestingly, left ventricular hypertrophy was found to be an independent correlate for all three: CHD, CVD, and PVD.
Conclusions:
Our study suggests that consideration of conventional cardiovascular risk factors as well as unconventional risk factors might better assess the risk for CAVD among HD patients.
Related Concept Videos
01:24Hemodialysis II: Procedure and Complications
01:30Coronary Artery Disease I: Introduction
01:25Hemodialysis I: Introduction