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Interdialytic Weight Gain and Cardiovascular Risk in Haemodialysis Patients With Chronic Kidney Disease: Findings
Kavya Rajendran1, Prasobh P V Mukundan2, Harrie Toms John3
1General Medicine, Epsom and St Helier University Hospitals, London, GBR.
Insights
Interdialytic weight gain over 3 kg and left ventricular hypertrophy are key predictors of adverse cardiovascular events in patients on maintenance hemodialysis. Managing fluid balance and blood pressure is crucial for reducing risks.
Area of Science:
- Nephrology
- Cardiology
- Clinical Research
Background:
- Cardiovascular disease (CVD) is a leading cause of death in patients undergoing maintenance hemodialysis (MHD).
- Identifying risk factors for cardiovascular (CV) events in this high-risk population is critical.
- Interdialytic weight gain (IDWG) is a potential modifiable factor influencing CV outcomes.
Purpose of the Study:
- To determine the frequency of CV events in MHD patients.
- To identify factors associated with CV events, including IDWG.
- To assess the impact of IDWG on clinical outcomes and mortality.
Main Methods:
- A prospective cohort study of 100 patients with chronic kidney disease (CKD) on MHD was conducted over 18 months.
- Cardiovascular events (MI, SCD, AF, CVA) and IDWG were meticulously documented.
- Statistical analyses included comparative tests and survival analysis.
Main Results:
- Cardiovascular events occurred in 23% of patients.
- Hypertension (HTN), left ventricular hypertrophy (LVH), and IDWG > 3 kg were significantly associated with increased CV risk (p=0.012, p=0.001, p=0.015 respectively).
- Overall mortality was 16%, predominantly from cardiovascular causes.
Conclusions:
- Left ventricular hypertrophy and interdialytic weight gain exceeding 3 kg are significant predictors of adverse outcomes in MHD patients.
- Optimizing fluid management and blood pressure control are essential strategies to mitigate cardiovascular morbidity.
Background:
Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients receiving maintenance haemodialysis (MHD). This study assessed the frequency of cardiovascular (CV) events, the factors associated with them, and the impact of interdialytic weight gain (IDWG) on clinical outcomes.
Materials And Methods:
A prospective cohort study was conducted at Fortis Hospital, Bangalore, India, involving 100 patients with chronic kidney disease (CKD) receiving MHD. Participants were followed for 18 months, and CV events, including myocardial infarction (MI), sudden cardiac death (SCD), atrial fibrillation (AF), and cerebrovascular accidents (CVA), were documented. IDWG was recorded at each dialysis session. Statistical analyses were performed using appropriate comparative tests for categorical variables and survival analysis methods.
Results:
CV events occurred in 23% of patients, with hypertension (HTN) (p = 0.012), left ventricular hypertrophy (LVH) (p = 0.001), and IDWG > 3 kg (p = 0.015) significantly associated with increased risk. The overall mortality was 16%, mostly from cardiovascular causes.
Conclusions:
IDWG > 3 kg and LVH were major predictors of adverse outcomes. Optimising fluid balance and blood pressure control may reduce cardiovascular morbidity in this population.
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