Conventional and optional cardiovascular risk factors in predicting outcome in hemodialysis patients
https://doi.org/10.15829/1728-8800-2020-2304
Abstract
Aim. To evaluate the frequency and effects on prognosis of conventional and optional cardiovascular risk (CVR) factors in hemodialysis patients.
Material and methods. The study included 82 patients receiving hemodialysis. Clinical examination was carried out. We also assesed heart rate variability and pulse wave velocity by photoplethysmography. To identify significant prognostic factors and determine the range of their values, the decision tree method was used.
Results. In hemodialysis patients, the prevalence of hypertension and overweight was higher than in the general population — 100% vs 33,8% and 51,2% vs 29,7%, respectively; the smoking prevalence was comparable — 25,6% vs 25,7%; the prevalence of hypercholesterolemia was lower than in the general population — 45,1% vs 57,6%. Optional CVR factors in hemodialysis patients were as follows: level of pulse pressure, duration of hypertension, hemoglobin level, pulse wave velocity, standard deviation normal to normal (SDNN), left ventricular ejection fraction. Based on a combination of significant CVR factors, 5 rules for predicting a favorable or unfavorable outcome in hemodialysis patients were identified.
Conclusion. The use of proposed rules allows to develop novel measures and improve current ones aimed at modifying CVR factors and increasing the survival of hemodialysis patients.
About the Authors
O. A. Bilevich
Omsk State Medical University
Russian Federation
Omsk
Russian Federation
Omsk
N. V. Ovsyannikov
Omsk State Medical University
Russian Federation
Omsk
Russian Federation
Omsk
E. V. Usacheva
Omsk State Medical University
Russian Federation
Omsk
Russian Federation
Omsk
O. M. Kulikova
Siberian State Automobile and Highway University
Russian Federation
Omsk
Russian Federation
Omsk
References
1. Fresenius Medical Care. Annual report 2018. https://www.freseniusmedicalcare.com/fileadmin/data/com/pdf/Media_Center/Publications/Annual_Reports/FME_Annual-Report_2018.pdf.
2. Tomilina NA, Andrusev AM, Peregudova NG, et al. Renal replacement therapy for End Stage Renal Disease in Russian Federation, 2010-2015. Russian National Renal Replacement Therapy Registry Report of Russian Public Organization of Nephrologists “Russian Dialysis Society”, Part 1. 2017;19(4):2- 68. (In Russ.) doi:10.28996/1680-4422-2017-4suppl-1-95.
3. Bradbury BD, Fissell RB, Albert JM, et al. Predictors of early mortality among incident US hemodialysis patients in the dialysis outcomes and practice patterns study (DOPPS) Clin J Am Soc Nephrol. 2007;2(1):89-99. doi:10.2215/CJN.01170905.
4. Steenkamp R, Shaw C, Feest T. UK Renal Registry 15th annual report: chapter 5 survival and causes of death of UK adult patients on renal replacement therapy in 2011: national and centrespecific analyses. Nephrol Clin Pract. 2013;123(suppl. 1):93-123. doi:10.1159/000353324.
5. Jager DJ, Grootendorst DC, Jager KJ, et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA. 2009;302(16):1782-9. doi:10.1001/jama.2009.1488.
6. United States Renal Data System. 2018 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2018. Available from: https://www.usrds.org/adr.aspx
7. Landray MJ, Thambyrajah J, McGlynn FJ, et al. Epidemiological evaluation of known and suspected cardiovascular risk factors in chronic renal impairment. Am J Kidney Dis. 2001;38(3):537-46. doi:10.1053/ajkd.2001.26850.
8. Shlipak MG, Fried LF, Cushman M, et al. Cardiovascular mortality risk in chronic kidney disease: Comparison of traditional and novel risk factors. JAMA. 2005;293(14):1737-45. doi:10.1001/jama.293.14.1737.
9. Kalantar-Zadeh K, Block G, Humphreys MH, et al. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int. 2003;63(3):793-808. doi:10.1046/j.1523-1755.2003.00803.x
10. Novikov AI, Romanov AA, Nazarov AG, et al. Method for determination of structural changes of large arteries on the characteristics of the peripheral pulse wave: comparison with high-resolution ultrasound. Therapeutic archive. 2007;9:54-9. (In Russ.)
11. Bunova SS, Bilevich OA, Semchenko SB. Factors affecting the stiffness of the arteries in patients with end-stage chronic renal failure who are on different types of replacement therapy. Nephrology and dialysis. 2014;16(3):359-63. (In Russ.)
12. Chan CT, Chertow GM, Daugirdas JT, et al. Effects of daily hemodialysis on heart rate variability: results from the Frequent Hemodialysis Network (FHN) Daily Trial. Nephrol Dial Transplant. 2014;29(1):168-78. doi:10.1093/ndt/gft212.
13. Grundy SM, Bazzarre T, Cleeman J, et al. Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: medical office assessment: Writing Group I. Circulation. 2000;101(1):E3-11. doi:10.1161/01.cir.101.1.e3
14. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4-11. (In Russ.) doi: 10.15829/1728-8800-2014-6-4-11.
Review
For citations:
Bilevich O.A., Ovsyannikov N.V., Usacheva E.V., Kulikova O.M. Conventional and optional cardiovascular risk factors in predicting outcome in hemodialysis patients. Cardiovascular Therapy and Prevention. 2020;19(3):2304. (In Russ.) https://doi.org/10.15829/1728-8800-2020-2304
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