title: Cardiothoracic ratio, malnutrition, inflammation, and two-year mortality in non-diabetic patients on maintenance hemodialysis.
abstract: OBJECTIVE
  Cardiothoracic ratio (CTR) is associated with left ventricular mass, left ventricular systolic dysfunction and mortality in patients with hypertension or chronic cardiovascular disease. The clinical significance of CTR in non-diabetic maintenance hemodialysis (MHD) patients remains unclear.
  
  
  METHODS
  468 non-diabetic MHD patients were enrolled. Geographic, hematological, biochemical and dialysis-related data were obtained. The patients were analyzed for nutritional and inflammatory markers as well as CTR. All patients were followed up for 2 years to investigate the risks for mortality.
  
  
  RESULTS
  Chi-square analysis showed that the incidence of malnutrition and inflammation was significantly higher in patients with CTR >60% than in patients with CTR <or=60%. CTR positively correlated with high-sensitivity C-reactive protein (hsCRP) levels but negatively correlated with albumin levels. 29 patients (6.2%) had expired by the end of the study. Cox multivariate analysis revealed that CTR significantly predicts both all-cause and cardiovascular-cause 2-year mortality in non-diabetic MHD patients.
  
  
  CONCLUSIONS
  CTR is an indicator of inflammation and nutritional status in non-diabetic MHD patients and can predict 2-year mortality in these patients. The analytical results of this study support continued efforts to reduce CTR and treat underlying causes in patients with CTR >50%.
authors.affiliation: Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: Kuan-Hsing
authors.initials: KH
authors.lastname: Chen
authors.forename: Dan-Tzu
authors.initials: DT
authors.lastname: Lin-Tan
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Huang
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Hung
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Jeng-Yi
authors.initials: JY
authors.lastname: Huang
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality; D003935:Diagnostic Techniques, Cardiovascular / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D007249:Inflammation; D007676:Kidney Failure, Chronic; D008297:Male; D044342:Malnutrition; D008875:Middle Aged; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic / Q000379:methods* / Q000592:standards; D006435:Renal Dialysis; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left