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Open Access Research article

Cardiovascular determinants of prognosis in normotensive hemodialysis patients

Wen-Chung Yu15, Yao-Ping Lin15, Shao-Yuan Chuang3, I-Feng Lin4 and Chen-Huan Chenb245*

Author Affiliations

1 Department of Medicine, Taipei, Taiwan

2 Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

3 Institute of Population Health Sciences, National Health Research Institutes, Taipei, Taiwan

4 Department of Public Health, Taipei, Taiwan

5 Department of Medicine,, National Yang-Ming University, Taipei, Taiwan

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BMC Nephrology 2012, 13:115  doi:10.1186/1471-2369-13-115

Published: 20 September 2012

Abstract

Background

Normotension has been hold to be the goal of hemodialysis. It remains obscure which cardiovascular parameter determines the prognosis in these normotensive hemodialysis patients.

Methods

We prospectively enrolled 145 hemodialysis patients, who had attained normotension without anti-hypertensive medications, and followed them for 72.6 ± 28.5 months. Important cardiovascular parameters were obtained at enrollment. Predictors for all-cause and cardiovascular mortalities were identified with the Cox model.

Results

There were 45 (18 cardiovascular/27 non-cardiovascular) deaths occurred during follow-up. Age, diabetes, left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), carotid intima-media thickness (CIMT), and aortic pulse wave velocity (PWV) were significant predictors for all-cause and cardiovascular mortalities. After adjustment for age and diabetes, only LVEF was significantly associated with all-cause mortality. LVEF was significantly associated with cardiovascular mortality. LVEF remained as a significant independent predictor of cardiovascular death after adjusting for age, diabetes, LVMI, CIMT, or PWV, respectively.

Conclusion

LVEF is the independent predictor for all-cause and cardiovascular mortalities in the normotensive hemodialysis patients.

Keywords:
Arterial stiffness; End-stage renal disease; Hypertension; Left ventricular function; Mortality