INTEGRATED CENTRAL BLOOD PRESSURE-AORTIC STIFFNESS RISK CATEGORIES AND CARDIOVASCULAR MORTALITY IN END-STAGE RENAL DISEASE

Abstract

Objective: Our aim was to study the predictive power of ICPS risk categories on cardiovascular (CV) mortality in end-stage renal disease (ESRD) patients on hemodialysis therapy. Design and method: In our retrospective cohort study 91 patients were involved from two dialysis centers. Pulse wave velocity (PWV), central systolic blood pressure (cSBP) and central pulse pressure (cPP) were measured with tonometric method, patients were followed for a median of 29.5 months and CV mortality was registered. Patients were classified into tertiles based on their PWV, cSBP and cPP values. After the analysis of the predictive values of the tertiles of the identical parameters, patients were scored. One score was given, when a patient had a third tertile value of cSBP or a second or third tertile value of PWV or cPP. Then the CV outcome was analyzed with Cox regression analysis of the groups of patients with different ICPS scores and three ICPS risk categories were defined: average (0–1 point), high (2 points) and very high (3 points). Results: During follow-up 31 events occurred. After adjustment for multiple factors, compared with the average ICPS risk category group (n = 35; 38%), those, who were in the high risk group (n = 33; 30%) showed a tendency for significantly higher hazard ratio (HR) of CV mortality (HR = 2.62, 95% confidence interval (CI):0.82–8.43), while patients in the very high ICPS risk category (n = 23; 21%) had a markedly increased risk (HR = 10.03, CI:1.67–60.42). Conclusions: The ICPS risk categories can help in the identification of ESRD patients with high CV risk.