POS-379 CARDIOVASCULAR INJURY MARKERS IN LONG-TERM HEMODIALYSIS PATIENTS: A SINGLE-CENTER STUDY

Abstract

Heart failure and related sudden cardiac death are the main causes of death in dialysis patients, so searching for cardiovascular injury (CV) indicators may improve the overall survival of such patients. The aim was to identify the N-terminal pro-brain natriuretic peptide (NT-proBNP) cut-off points associated with increased survival in dialysis patients and select echocardiographic markers of CV injury and increased mortality. A single-center prospective trial included 13 hemodialysis (HD) patients without any medical history of CV disease with an age at dialysis onset <65 years old and dialysis vintage of 5-22 years. In April 2018, all patients underwent echocardiography (Echo); serum NT-proBNP level was also carried out. Depending on the NT-proBNP level, 2 groups of patients were identified: the 1st group included patients with NT-proBNP value >3000 pg/ml, the 2d group had value ≤3000 pg/ml. At the end of a follow-up period of 2.5 years, the outcomes were evaluated. A summary of patients' characteristics is shown in the table below. In the 1st group, patients were older and more often were men. 62.5% of these patients had resting wall motion abnormalities (RWMA), 25% had mitral annular calcification (MAC). All patients who had these abnormalities died during the follow-up. In the 2d group, patients didn't have any RWMA or MAC. During follow-up, 75% of patients from the 1st group died, 25% were transplanted, and were alive after transplantation. Among the patients of the 2nd group, 40% underwent kidney transplantation (of which 1 patient died after transplantation due to acute liver failure), 60% were alive and were on HD. Tabled 1Parameter1st group2d groupNT-proBNP, pg/ml>3000≤3000Number, N (%)8 (61.5)5 (38.5)Male, N (%)5 (62.5)1 (20)Median [25%;75%]Age, years55.5 [47;58.5]29 [24;43]Dialysis vintage, years8 [6;9.5]10 [6;11]EchoRWMA, N (%)5 (62.5)0MAC, N (%)2 (25)0OutcomesDied, N (%)6 (75)0Transplanted, N (%)2 (25)2 (40)Alive, undergoing HD, N (%)03 (60) Open table in a new tab NT-proBNP level of ≤3000 pg/ml may be an optimal cut-off point for overall survival, but this requires clarification and research on more dialysis patients. The NT-proBNP level is not affected by dialysis vintage but depends on age. The presence of RWMA and MAC increases the risk of death in dialysis patients and is associated with higher NT-proBNP levels.