Association between peripheral arterial occlusive disease and cardiothoracic ratio in patients on chronic hemodialysis

Liou, Kang-Yi; Liou, Hung-Hsiang; Fang, Yu-Wei; Leu, Jyh-Gang; Tsai, Ming-Hsien

doi:10.1038/srep38458

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…The CTR, which is the ratio of cardiac and thoracic diameters, is estimated according to chest X-ray [26], and is usually regarded as a predictor of left ventricular systolic dysfunction in LTHD patients [27]. We previously reported that CTR was not only related to peripheral arterial disease [28], but also had a negative impact on long-term survival in our LTHD patients [3,29,30]. An association between CTR and inflammation or malnutrition in non-diabetic patients who underwent HD was shown by Chen et al [31].…”

Section: Discussionmentioning

confidence: 99%

Higher Intra-Dialysis Serum Phosphorus Reduction Ratio as a Predictor of Mortality in Patients on Long-Term Hemodialysis

Fang¹,

Leu²,

Tsai³

et al. 2019

Med Sci Monit

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BackgroundRapid shifting between extracellular and intracellular phosphorus can occur during dialysis sessions, which can cause aberrant intracellular signaling in long-term hemodialysis (LTHD) patients. However, the effect of these intra-dialysis fluctuations of phosphorus on clinical outcomes has not been examined. Therefore, we investigated the relationship between intradialysis serum phosphorus reduction ratio (IDSPRR) and mortality in LTHD patients.Material/MethodsThis was a retrospective, observational cohort study to assess the predictive power of IDSPRR (>0.63 vs. ≤0.63) on mortality in a total of 805 LTHD patients. All these fatal events were analyzed using the Cox proportional hazards regression model.ResultsAfter multivariable analysis, baseline IDSPRR higher than 0.63 was significantly predictive of all-cause mortality (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.10–2.26), but not for cardiovascular (CV) mortality (HR: 1.41; 95% CI: 0.91–2.18). However, when time-varied IDSPRRs were applied, a value greater than 0.63 was not only significantly predictive of all-cause mortality (HR: 1.74, 95% CI: 1.16–2.63), but also CV mortality (HR: 2.04, 95% CI: 1.23–3.40).ConclusionsHigh IDSPRR (>0.63) is independently associated with increased all-cause and CV mortality, which shows the negative effect of rapid intracellular phosphorus-shifting on LTHD patients.

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Section: Discussionmentioning

confidence: 99%

Higher Intra-Dialysis Serum Phosphorus Reduction Ratio as a Predictor of Mortality in Patients on Long-Term Hemodialysis

Fang¹,

Leu²,

Tsai³

et al. 2019

Med Sci Monit

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“…Moreover, in our subgroup analysis, a higher serum aluminum level was not significantly associated with cardiomegaly in groups with hemoglobin levels ≤9 g/dL or CVD history. This may have occurred because anemia and CVD are both strong risk factors for the development of cardiomegaly in patients on CHD [ 32 , 33 ] and may negate the impact of the hazardous effect of aluminum on the heart.…”

Section: Discussionmentioning

confidence: 99%

Association between serum aluminum levels and cardiothoracic ratio in patients on chronic hemodialysis

Wang¹,

Fang

Leu

et al. 2017

PLoS ONE

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The cardiothoracic ratio (CTR) and serum aluminum levels are both associated with mortality in hemodialysis patients. However, limited data regarding the association between serum aluminum levels and the CTR have been published to date. Therefore, we aimed to elucidate this association in patients on chronic hemodialysis (CHD). We investigated the association between the serum aluminum level and the CTR in CHD in a retrospective cross-sectional study of 547 Taiwanese patients on CHD. The mean age of patients was 62.5±13.2 years, with a mean hemodialysis time of 7.1±5.2 years. Among the patients, 36.9% were diabetic and 47.9% were male. After natural logarithmic transformation (ln(aluminum)), the serum aluminum level exhibited an independent and linear relationship with the CTR (β: 1.40, 95% confidence interval (CI), 0.6–2.2). A high serum aluminum level (≥6 ng/dL) was significantly associated with a CTR >0.5 in the crude analysis (odds ratio (OR): 2.15, 95% CI, 1.52–3.04) and remained significant after multivariable adjustment (OR: 2.45, 95% CI, 1.63–3.67). Moreover, the ln(aluminum) value was significantly associated with a CTR >0.5 (OR: 1.71, 95%CI, 1.28–2.29) in multivariable analysis, indicating a dose effect of aluminum on cardiomegaly. In conclusion, the serum aluminum level was independently associated with cardiac remodeling (elevated CTR) in patients on CHD.

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“…Fifty-five subjects do not suffer from pleural effusion (55%), 31 subjects suffer from unilateral pleural effusion (31%), and 14 subjects suffer from bilateral pleural effusion (14%). 11 Several diseases that accompany CKD such as DM, hypertension, anemia, malnutrition, chronic inflammation, and body fluid status contribute to cardiomegaly. 11 There are several mechanisms in which cardiomegaly increases risk of death or other cardiovascular diseases.…”

Section: Frequency Distribution Of Chronic Kidney Disease Patients Undergoing Hemodialysis By Thorax Imaging Findingsmentioning

confidence: 99%

“…10 Cardiomegaly commonly occurs in patients with uremia and further increased the progression of cardiovascular disease in chronic hemodialysis patients. 11 Non-vascular complications reported in chronic kidney disease patients undergoing hemodialysis include pleural effusion and pulmonary edema. 12 Pleural effusion in hemodialysis patients may be caused by heart failure, excess fluid volume, infection, malignant tumors, and underlying diseases.…”

Section: Introductionmentioning

confidence: 99%

Pathological Findings in Chest Radiographs of Chronic Kidney Disease Patients Undergoing Hemodialysis

Utami

Uli²,

Septadina

2021

Sriwijaya Journal of Medicine

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Chronic kidney disease is a condition in which there is destruction of the kidneys along with structural or functional abnormalities, with or without decreased glomerular filtration rate for more than 3 months. The common treatment for this condition is hemodialysis, however, it may cause complications, specifically cardiovascular and non-cardiovascular system dysfunctions that can be observed through thorax imaging. This study aims to observe pathologic thorax imaging findings on chronic kidney disease patients undergoing hemodialysis at RSUP Dr. Mohammad Hoesin Palembang. This study is a descriptive study using a cross-sectional design. The data is gathered from medical records from the Medical Records & Radiology Department of RSUP Dr. Mohammad Hoesin Palembang that have passed the inclusion and exclusion criteria. The data is processed using the SPSS application version 25. The results of this study indicate that, based on risk factors, patients are generally in the 55-64 age range (41%), female (60%), and with a normal BMI/normal weight (52%). Based on the patients’ comorbid diseases, patients mostly have hypertension (59%), followed by diabetes mellitus (46%). Analysis of the chest radiographs indicate that (70%) of patients have cardiomegaly; (22%) of patients have grade 1, (15%) have grade 2, (7%) have grade 3 aortic arch calcification; (49%) have pulmonary edema; (31%) have unilateral pleural effusion, and (14%) have bilateral pleural effusion. The majority of chronic kidney disease patients undergoing hemodialysis at RSUP Dr. Mohammad Hoesin Palembang are in the 55-64 age range, female, and with normal BMI. The most common comorbid conditions are hypertension and diabetes mellitus. Analysis of the chest radiographs indicate that the majority of patients have cardiomegaly; grade 1, 2, and 3 aortic arch calcification; pulmonary edema; unilateral and bilateral pleural effusion.

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Association between peripheral arterial occlusive disease and cardiothoracic ratio in patients on chronic hemodialysis

Cited by 4 publications

References 29 publications

Higher Intra-Dialysis Serum Phosphorus Reduction Ratio as a Predictor of Mortality in Patients on Long-Term Hemodialysis

Higher Intra-Dialysis Serum Phosphorus Reduction Ratio as a Predictor of Mortality in Patients on Long-Term Hemodialysis

Association between serum aluminum levels and cardiothoracic ratio in patients on chronic hemodialysis

Pathological Findings in Chest Radiographs of Chronic Kidney Disease Patients Undergoing Hemodialysis

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