Cardiovascular morbidity and mortality in patients treated with hemodialysis: Epidemiological analysis

Petrović, Dejan; Stojimirovic, Biljana

doi:10.2298/vsp0812893p

Cited by 12 publications

(11 citation statements)

References 32 publications

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“…Ischemic heart disease, LV hypertrophy, cardiac failure, disturbed myocardial ultrastructure and function, increased sympathetic activity and fast electrolyte shifts during HD all contribute significantly to the appearance of sudden cardiac death in these patients (6,17). The average annual cardiovascular mortality rate in HD patients in this study of 8.51% is similar to the 9% reported by other authors (17,18). Increased CRP, cTnT, cTnI and LVMi were identified as independent risk factors for cardiovascular mortality in our study group.…”

Section: Discussionsupporting

confidence: 82%

Cardiovascular Mortality in Hemodialysis Patients: Clinical and Epidemiological Analysis

Petrović¹,

Obrenović²,

Trbojević-Stanković³

et al. 2011

Journal of Medical Biochemistry

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Summary: Cardiovascular diseases are the leading cause of death in hemodialysis (HD) patients. The annual cardiovascular mortality rate in these patients is 9%, with left ventricular (LV) hypertrophy, ischemic heart disease and heart failure being the most prevalent causes of death. The aim of this study was to determine the cardiovascular mortality rate and estimate the influence of risk factors on cardiovascular mortality in HD patients. A total of 115 pa tients undergoing HD for at least 6 months were inves ti gated. Initially a cross-sectional study was performed, follo wed by a two-year follow-up study. Beside the standard bio chemical parameters, C-reactive protein (CRP), homo cysteine, cardiac troponins (cTn) and the echocardiographic parameters of LV morphology and function (LV mass index, LV fractional shortening, LV ejection fraction) were deter mined. Results were analyzed using Cox regression analysis, Kaplan-Meier and Log-Rank tests. The average one-year cardiovascular mortality rate was 8.51%. Multivariate Cox regression analysis identified increased CRP, cTn T and I, and LV mass index as independent risk factors for cardiovascular mortality. Patients with cTnT > 0.10 ng/mL and CRP > 10 mg/L had significantly higher cardio vas cular mortality risk (p < 0.01) than patients with cTnT > 0.10 ng/mL and CRP ≤ 10 mg/L and those with cTnT ≤ 0.10 ng/mL and CRP ≤ 10 mg/L (p < 0.01). HD pa tients with high cTnT and CRP have a higher cardiovascular mor tality risk.Keywords: C-reactive protein, cardiovascular mortality, hemodialysis, risk factors, troponin T Kratak sadr`aj: Kardiovaskularne bolesti su vode}i uzrok smrti bolesnika koji se le~e hemodijalizom. Jednogodi{nja stopa kardiovaskularnog mortaliteta iznosi 9%, a od kardiovaskularnih bolesti najve}u prevalenciju imaju hipertrofija leve komore, ishemijska bolest srca i sr~ana slabost. Cilj rada je bio da se utvrdi stopa kardiovaskularnog mortaliteta i da se ispita uticaj faktora rizika na razvoj kardiovas kularnog mor taliteta kod bolesnika na hemodijalizi. Ispitano je 115 bolesnika koji se le~e hemodijalizom du`e od {est meseci. Prvo je obavljena studija preseka, a zatim pra}enje bolesnika u dvogodi{njem vremenskom periodu. Parametri ispitivanja obuhvatili su koncentraciju C-reaktivnog proteina, homoci steina, sr~anog troponina T i I, kao i ehokardio grafske pa ra metre morfologije i funkcije leve komore. Za statisti~ku analizu dobijenih podataka kori{}eni su Co xova regresiona analiza, Kaplan-Meierov test i Log-Ran kov test. Utvr|eno je da prose~na jednogodi{nja stopa kardiovaskularnog mor taliteta iznosi 8,51%. Multi vari jantna Co xo va regre siona analiza je po kazala da su pove}ana koncentracija C-reaktivnog prote ina, sr~anog troponina T i I, i pove}an indeks mase leve komore nezavisni faktori rizika za na stanak kardio vasku larnog mortaliteta. Bolesnici kod kojih je koncentracija sr~a nog troponina T -cTnT > 0,10 ng/mL i koncentracija CRP > 10 mg/L imaju statisti~ki veoma zna ~ajno (p < 0,01) ve}i rizik od kardiovaskularnog mortaliteta u odnosu n...

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Section: Discussionsupporting

confidence: 82%

Cardiovascular Mortality in Hemodialysis Patients: Clinical and Epidemiological Analysis

Petrović¹,

Obrenović²,

Trbojević-Stanković³

et al. 2011

Journal of Medical Biochemistry

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“…Cardiovascular disease represents the leading cause of mortality in HD patients (12)(13)(14)(15). Several risk factors, such as anemia, hypertension, volume overload, shunt blood flow, oxidative stress, microinflammation, hypoalbuminemia, hyperhomocysteinemia and hyperphosphatemia have been identified as cardiovascular risk factors in the HD population (16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Hyperphosphatemia - The Risk Factor for Adverse Outcome in Maintenance Hemodialysis Patients

Petrović¹,

Obrenović²,

Trbojević-Stanković³

et al. 2012

Journal of Medical Biochemistry

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Summary: Hyperphosphatemia is a potent stimulator of vascular and valvular calcifications in hemodialysis patients. To determine the prevalence of hyperphosphatemia and assess its effect on the outcome of hemodialysis patients, a total of 115 chronic hemodialysis patients were studied. Laboratory parameters were determined at baseline, and after 12 and 24 months of follow-up. Valvular calcification was assessed with echocardiography. Laboratory parameters were statistically analyzed with ANOVA. Survival analysis was performed with the Kaplan-Meier test and Log-Rank test. Hyperphosphate mia was present in 31.30% of the patients, high calcium-phosphate (Ca x P) product in 36.52% and valvular calcifications in 48.70%. Patients with serum phosphate >2.10 mmol/L and Ca x P product >5.65 mmol 2 /L 2 at baseline were at high risk for all-cause and cardiovascular mortality. Hyperphosphatemia is a risk factor for adverse outcome in patients on regular hemodialysis. Keywords: hemodialysis, hyperphosphatemia, cardiovascular mortalityKratak sadr`aj: Hiperfosfatemija ima zna~ajnu ulogu u kalcifikaciji sr~anih valvula i koronarnih arterija bolesnika na hemodijalizi. Radi utvr|ivanja prevalencije hiperfosfatemije i ispitivanja njenog uticaja na ishod bolesnika koji se le~e redovnim hemodijalizama, ispitano je 115 bolesnika koji se le~e redovnim hemodija lizama du`e od 6 meseci. Laboratorijsko ispitivanje je sprovedeno na po~etku, posle 12 i 24 meseci pra}enja bolesnika. Kalcifikacija sr~anih valvula je procenjivana ehokardiografskom metodom. Za statisti~ku ana lizu podataka kori{}eni su jednofaktorska parametarska analiza varijanse -ANOVA i analiza pre`ivljavanja (Kaplan--Meier test, Log-Rank test). Hiperfosfatemiju ima 31,30% bolesnika, pove}an proizvod solubiliteta 36,52% bolesnika, a kalcifikaciju sr~anih valvula 48,70% bolesnika. Bolesnici kod kojih je na po~etku ispitivanja koncentracija fosfata u serumu >2,10 mmol/L i pro izvod solubiliteta >5,65 mmol 2 /L 2 imaju visok rizik za raz voj op{teg i kardiovaskularnog mortaliteta. Hiperfosfatemija je faktor rizika za razvoj nepovoljnog ishoda kod bolesnika koji se le~e redovnim hemodijalizama.

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“…The rate of cardiovascular mortality in this population is approximately 9% on an annual basis, with left ventricular hypertrophy, ischemic heart diseases and heart failure having the highest rates of mortality [1,2].…”

Section: Therapy Of Left Ventricular Hypertrophymentioning

confidence: 99%

“…Anaemia is an important cause of left ventricle hypertrophy, and a decrease in haemoglobin of 10 g/l is INTRODUCTION Cardiovascular diseases present a leading cause of death in patients treated with haemodialysis [1,2]. The rate of cardiovascular mortality in this population is approximately 9% on an annual basis, with left ventricular hypertrophy, ischemic heart diseases and heart failure having the highest rates of mortality [1,2].…”

Section: Therapy Of Left Ventricular Hypertrophymentioning

confidence: 99%

Diagnostics and therapy of left ventricular hypertrophy in haemodialysis patients

Petrović¹,

Jagić²,

Miloradović³

et al. 2011

Ser J Exp Clin Res

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Cardiovascular morbidity and mortality in patients treated with hemodialysis: Epidemiological analysis

Abstract: Patients on HD have high risk for cardiovascular morbidity and mortality.

Cited by 12 publications

References 32 publications

Cardiovascular Mortality in Hemodialysis Patients: Clinical and Epidemiological Analysis

Cardiovascular Mortality in Hemodialysis Patients: Clinical and Epidemiological Analysis

Hyperphosphatemia - The Risk Factor for Adverse Outcome in Maintenance Hemodialysis Patients

Diagnostics and therapy of left ventricular hypertrophy in haemodialysis patients

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