Hypervolemia, hypoalbuminemia and mitral calcification as markers of cardiovascular risk in peritoneal dialysis patients

Querido, Sara; Branco, Patrícia; Sousa, Henrique; Adragão, Teresa; Gonçalves, Pedro Araújo; Gaspar, Maria Augusta; Barata, José Diogo

doi:10.1016/j.repc.2016.12.014

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Hypoalbuminemia is also a risk factor for cardiovascular disease. 24,29 The present study demonstrated that serum albumin value in patients with IBIL ≥ 3.0 μmol/L was higher than that in patients with IBIL <3.0 μmol/L, which may have potentially increased the protective effect of IBIL which is albumin-bound. However, in multivariate Cox regression analysis, low IBIL was still an independent risk factor for cardiovascular events in MHD patients even after adjusting for serum albumin and other potential confounding factors.…”

Section: Discussionmentioning

confidence: 58%

Relationship Between Serum Indirect Bilirubin Levels and Cardiovascular Events and All-Cause Mortality in Maintenance Hemodialysis Patients

Chumakov¹,

Zhao²,

Fan³

et al. 2022

TCRM

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Purpose Unconjugated bilirubin is one of the most endogenous antioxidant substances. Mildly elevated total bilirubin concentrations may protect against cardiovascular disease and total death. However, most studies only focused on the association between serum total bilirubin and the risk of cardiovascular disease and total death. This study aimed to investigate the relationship between serum indirect bilirubin (IBIL) and the cardiovascular events in maintenance hemodialysis patients. Patients and Methods: This retrospective cohort study included 284 maintenance hemodialysis patients. Patients were divided into two groups according to the median IBIL level: high IBIL group (IBIL ≥3.0 μmol/L) and low IBIL group (IBIL <3.0 μmol/L). All demographic and laboratory data were recorded at baseline. The endpoint was cardiovascular events and all-cause mortality. Results During the median follow-up time of 62 months, 96 patients developed cardiovascular disease. There were 134 deaths. In Kaplan–Meier analysis curves, the risk of cardiovascular events in the low IBIL group was significantly higher than high IBIL group ( P < 0.001). In multivariate Cox regression analysis, the risk of cardiovascular events in high IBIL group was 0.484 times (95% CI 0.278–0.844, P = 0.010) the risk in low IBIL group. However, there was no significant association between serum IBIL level and all-cause mortality ( P = 0.269). Conclusion Our findings suggest that lower circulating IBIL levels were associated with the increased risk of cardiovascular events in maintenance hemodialysis patients.

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Section: Discussionmentioning

confidence: 58%

Relationship Between Serum Indirect Bilirubin Levels and Cardiovascular Events and All-Cause Mortality in Maintenance Hemodialysis Patients

Chumakov¹,

Zhao²,

Fan³

et al. 2022

TCRM

View full text Add to dashboard Cite

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“…Although HVC is a risk factor for adverse CEs and cardiovascular mortality [3], different studies have different predictions. Some studies suggested that AVC and MVC are associated with adverse CEs, while some reported that both AVC and MVC are associated with higher rates of adverse CEs [6, 24, 25]. The cumulative incidence of CE-free survival in the HVC group was significantly lower than that in the non-HVC group.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Heart Valve Calcification on Cardiovascular Events in Hemodialysis Patients without Central Venous Catheters

Huang

Zhang

et al. 2023

Cardiorenal Med

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Introduction: Heart valvular calcification (HVC) is an important predictor of cardiovascular events (CEs) and all-cause mortality in dialysis patients. Patients in the early stage of dialysis or those with central venous catheters (CVCs) are also at high risk of cardiovascular and all-cause mortality. It could be a confounding factor for the prognosis of HVC on CE. Methods: From March 2017 to April 2022, the prognosis of HVC on CE and all-cause mortality was studied retrospectively in 158 hemodialysis (HD) patients who used arteriovenous fistulas (AVFs) or arteriovenous grafts (AVGs) as vascular access and entered HD for more than 12 months. Results: Out of 158 patients, 70 (44.3%) were diagnosed with HVC via echocardiography. A total of 180 CEs occurred during follow-up. Among them, acute heart failure (AHF) accounted for 62.66%, and its prevalence was significantly higher in the HVC group than that in the non-HVC group (p <0.0001). The cumulative incidence of CE-free survival in the HVC group was significantly lower than that in the non-HVC group (p = 0.030). Only 11 patients died and there was no significant difference in all-cause mortality between the two groups (p = 0.560). Multivariate COX regression analyses showed that HD vintage, mitral valve calcification (MVC), and aortic valve regurgitation (AR)/aortic valve stenosis (AS) but not aortic valve calcification (AVC) were risk factors for CE (p <0.05). Conclusion: After excluding the factors of the early stage of HD and CVC, HVC remained a predictor of adverse CE in HD patients.

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“…A recent study found that patients with a history of cardiovascular events had elevated markers of cardiovascular events and were more likely to have cardiovascular events than patients with cardiovascular disease [ 11 ]. Several studies have shown that hypoalbuminemia is a risk factor for cardiovascular events in peritoneal dialysis patients [ 8 , 17 ]. Hypoalbuminemia was shown to be related to malnutrition, protein loss, and inflammation that promotes atherosclerosis of blood vessels, leading to cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

A nomogram predicts cardiovascular events in patients with peritoneal dialysis-associated peritonitis

Huang

et al. 2022

Renal Failure

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Objective To predict the risk factors for cardiovascular events within 5 years in patients with peritoneal dialysis-associated peritonitis and establish a nomogram for clinical prediction. Methods A prediction model was established by conducting an observational study in 150 patients with peritoneal dialysis-associated peritonitis obtained from the Information Database of AnHui Medical University Affiliated Hospital. The nomogram was constructed using the multivariate COX regression model. The C-index and the calibration plot were used to assess the discrimination and calibration of the prediction model. Results The elderly [HR = 2.453 (1.071–5.619)], history of cardiovascular events [HR = 2.296 (1.220–4.321)], alkaline phosphatase [HR = 1.004 (1.002–1.005)] and culture-positive [HR= 2.173 (1.009–4.682)] were identified as risk predictors of cardiovascular events, while serum albumin [HR = 0.396(0.170–0.924)] was identified as protective predictors of cardiovascular events. Combined with clinical studies, we constructed a nomogram based on the minimum value of the Akaike Information Criterion or Bayesian Information Criterion. The C index of the nomogram is 0.732, revealing great discrimination and appropriate calibration. Through the total score of the nomogram and the result of ROC, we classify patients into high-risk groups (cardiovascular events group) and low-risk groups (no cardiovascular events group). Cardiovascular events were significantly different for patients in the high-risk group compared to the low-risk group (HR = 3.862(2.202–6.772; p < 0.001). Conclusions The current novel nomogram can accurately predict cardiovascular events in patients with peritonitis associated with peritoneal dialysis. However, external validation is required before the model can be used in clinic settings.

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Hypervolemia, hypoalbuminemia and mitral calcification as markers of cardiovascular risk in peritoneal dialysis patients

Abstract: Traditional CV risk factors appear to have little impact on CV complications in PD patients. Nevertheless, hypervolemia, hypoalbuminemia and mitral calcifications were independent predictors of CV events or mortality in this group of patients.

Cited by 10 publications

References 25 publications

Relationship Between Serum Indirect Bilirubin Levels and Cardiovascular Events and All-Cause Mortality in Maintenance Hemodialysis Patients

Relationship Between Serum Indirect Bilirubin Levels and Cardiovascular Events and All-Cause Mortality in Maintenance Hemodialysis Patients

Prognosis of Heart Valve Calcification on Cardiovascular Events in Hemodialysis Patients without Central Venous Catheters

A nomogram predicts cardiovascular events in patients with peritoneal dialysis-associated peritonitis

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