Hospitalization rate and outcomes in patients with left ventricular dysfunction receiving hemodialysis

Abstract

IntroductionLeft ventricular dysfunction (LVD) is characterized as left ventricular ejection fraction (EF) below half of the systolic capacity of the left ventricle. Patients on hemodialysis have higher risk of developing LVD than the general population. Our aim was to assess hospitalization rate and outcomes in hemodialysis patients with LVD.Patients and methodsAll patients ≥18 years old, who started hemodialysis therapy at King Abdulaziz University Hospital between January 2011 and December 2011, were identified using medical records of hemodialysis unit. Patients were then divided into three groups, according to their EF results prior to the initiation of hemodialysis, as patients with EF <40%, EF between 40% and 49%, and EF ≥50%. Patients were then followed for 5 years by reviewing their hospital records to assess their outcomes, hospital admissions, and length of hospital stay.ResultsAnalysis included 333 patients. Patients with EF <40% were 40, 36 patients with EF 40%–49%, and 257 patients had an EF >50%. Patients with EF <50% were significantly older than patients with EF >50% (P=0.002). Diabetes mellitus and hypertension were more prevalent in patients with EF <40% and EF 40%–49% when compared with patients with EF >50% (P<0.001, P=0.002). The average length of stay between the three groups was significantly different (P=0.007). Intensive care unit admissions were significantly different when comparing the three groups (P=0.013) and was found to be an independent risk factor for mortality in our patients. Half of the patients with EF <40% and 44% of patients with EF of 40%–49% died compared with only 27% of patients with EF >50% (P=0.002). However, Kaplan–Meier analysis showed no significant difference in the survival time among the three groups (P=0.845).ConclusionMortality and morbidity increased in patients with LVD on hemodialysis compared with patients with normal EF.

Clinical Outcomes in Patients on Hemodialysis with Congestive Heart Failure

“…Studies have shown that HD patients with CHF have a higher hospitalization risk [18,20]. However, in our study, the all-hospitalization risk was similar among HD patients with and without CHF.…”

Findings of Cardiovascular Workup of Kidney Transplant Candidates: A Retrospective Study of a Single-Center in Saudi Arabia

“…We found only two studies addressing echocardiographic findings among ESKD patients in KSA and no other previous studies among KTRs were found. Albeshri et al studied 333 Saudi HD patients and demonstrated that LV dysfunction (EF <40) was associated with higher morbidity and mortality rates when compared with patients with normal EF [ 38 ]. In another single-center study of 192 Saudi patients, Sharabas et al showed that PD patients had higher urine output and better Kt/V values, however, they were more edematous and using more antihypertensive medications and had a lower EF [ 30 ].…”

Blood pressure variability in hemodialysis patients: prognostic significance and treatment possibilities

“…Распространенность артериальной гипертензии у пациентов на программном гемодиализе (ГД), по данным диализных центров, достигает 95% [1]. В условиях отсутствия адекватной коррекции артериальная гипертензия является независимым фактором риска гипертрофии левого желудочка, запускающим механизм патологического ремоделирования миокарда еще на начальных стадиях хронической болезни почек [2]. Структурные изменения миокарда приводят к ухудшению его функции, клиническими последствиями являются нарушения ритма сердца и прогрессирование хронической сердечной недостаточности [3].…”