Aortic pulse wave velocity is a strong predictor of all – cause and cardiovascular mortality in chronic dialysis patients

Abstract

Background/Aims: The aim of this study was to investigate all-cause and cardiovascular mortality in chronic hemodialysis patients (CHP) and to identify the determinants of mortality predictors. Methods: In this study with 3 years of follow-up period, we studied a cohort of 80 CHPs. Mean age at entry was 59.3 ± 11.8 years (duration of dialysis 5.47 ± 5.16 years). At entry, together with standard clinical and biochemical analyses, pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and common femoral artery flow signals by Doppler ultrasound. Results: The mean PWV (m/s) was presented at entry: in survived (12.5 ± 2.01) and deceased (13.13 ± 1.70) patients. The PWV cutoff point (by ROC curves) was 11.8. The regression coefficients (b) and Exp (b) hazard ratio coefficients of covariates in Cox-regression survival analysis in all-cause and CV outcomes was: PWV (b = 0.2617, Exp[b] = 1.2992, p = 0.0027; b = 0.3569, Exp[b] = 1.4289, p = 0.0005), CRP (b = 0.0776, Exp[b] = 1.0807, p = 0.0001; b = 0.0832, Exp[b] = 1.0868, p = 0.0001) and albumin (b = −0.1302, Exp[b] = 0.8779, p = 0.0089; b = −0.1881, 0.8285, p = 0.0030), respectively. Relative risk for exposed groups according to all-cause and CV events was 4.2976 (95% CI = 1.6051–11.5071) and 14.3590 (95% CI = 1.6051–11.5071), p = 0.0037, respectively. Conclusions: We conclude that PWV, CRP and serum albumin are strong independent predictors of overall and CV mortality in patients undergoing dialysis.