Prevalence of Cardiovascular Risk Factors in Hemodialysis Patients - The CORDIAL Study

Abstract

BackgroundThere are scarce epidemiological data on cardiovascular risk profile of chronic hemodialysis patients in Brazil.ObjectiveThe CORDIAL study was designed to evaluate cardiovascular risk factors and follow up a hemodialysis population in a Brazilian metropolitan city.MethodsAll patients undergoing regular hemodialysis for chronic renal failure in all fifteen nephrology centers of Porto Alegre were considered for inclusion in the baseline phase of the CORDIAL study. Clinical, laboratory and demographic data were obtained in medical records and in structured individual interviews performed in all patients by trained researchers.ResultsA total of 1215 patients were included (97.3% of all hemodialysis patients in the city of Porto Alegre). Their average age was 58.3 years old, 59.5% were male and 62.8% were white. The prevalence of cardiovascular risk factors observed was 87.5% for hypertension, 84.7% for dyslipidemia, 73.1% for sedentary lifestyle, 53.7% for tobacco use, and 35.8% for diabetes. In a multivariate adjusted analysis, we found that sedentary lifestyle (p = 0.032, PR 1.08 - 95%CI: 1.01-1.15), dyslipidemia (p = 0.019, PR 1.08 - 95%CI: 1.01-1.14), and obesity (p < 0.001, PR 1.96 - 95%CI: 1.45-2.63) were more frequent in women; and hypertension (p = 0.018, PR 1.06 - 95%CI: 1.01-1.11) and tobacco use (p = 0.006, PR 2.7 - 95%CI: 1.79-4.17) were more often found among patients under 65 years old. Sedentary lifestyle was independently associated with time in dialysis less than 12 months (p < 0.001, PR 1.23 - 95% CI: 1.14-1.33).ConclusionHemodialysis patients in this southern metropolitan Brazilian city have a high prevalence of cardiovascular risk factors resembling many northern countries.

Identificação de risco cardiovascular pela razão triglicerídeo/HDL-colesterol em pacientes com doença renal crônica em hemodiálise

“…Sabe-se que a população com DRC apresenta uma elevada prevalência de fatores de risco cardiovascular, como dislipidemia, obesidade, hipertensão e tabagismo. Alguns estudos evidenciam também a uremia na patogênese da doença cardiovascular, bem como albuminúria e/ou redução da taxa de filtração glomerular [21][22][23][24][25][26][27].…”

Dyslipidemia in patients with chronic kidney disease: etiology and management

“…5 These risk factors can be both traditional ones such as age, male gender, diabetes, obesity, hypertension, and dyslipidemia and non-traditional uremia-related risk factors such as anemia, hyperhomocysteinemia, mineral bone disease-CKD with hyperparathyroidism, oxidative stress, hypoalbuminemia, and chronic inflammation. 3,4 In the general population, high total cholesterol (TC), high low-density lipoprotein (LDL) cholesterol, high triglyceride, and low high-density lipoprotein (HDL) cholesterol are all well-established risk factors for CVD development.…”

Cardiovascular risk and lifestyle in patients with chronic kidney disease

“…More than half (59.3%) of the 386 patients evaluated in a general medical clinic of a university hospital in the city of São Paulo presented arterial hypertension. This is because, besides to being one of the most important causes for the establishment and development of the disease, arterial hypertension is a consequence of chronic kidney disease (6,(13)(14) .…”