Clustering of unconventional cardiovascular risk factors among Taiwanese hemodialysis patients.
BACKGROUND
Cardiovascular disease (CAVD) is the most common cause of mortality for chronic hemodialysis (HD) patients, yet the risk factors for the events have not been well established.


METHODS
We conducted a multicenter cross-sectional survey in 995 chronic HD patients recruited from 12 HD centers in Taiwan to investigate the prevalence of CAVD, including coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD), and related them to 30 different parameters.


RESULTS
The mean age of 995 patients (499 males/496 females) was 56.4 +/- 12.3 years, and average HD duration was 59.8 +/- 51.2 months. The prevalence rates of CHD, CVD, and PVD were 24.0, 6.0, and 5.3%, respectively. Results of our multivariate logistic regression analysis showed that out of the conventional CAVD risk factors, only old age and diabetes could be significantly associated with CAVD. Meanwhile, we found some novel clinical correlates, including low apolipoprotein A-I and creatinine for CHD, low uric acid for CVD, and low hematocrit and low diastolic blood pressure for PVD. Interestingly, left ventricular hypertrophy was found to be an independent correlate for all three: CHD, CVD, and PVD.


CONCLUSIONS
Our study suggests that consideration of conventional cardiovascular risk factors as well as unconventional risk factors might better assess the risk for CAVD among HD patients.
Division of Nephrology, Department of Internal Medicine, E-DA Hospital/I-Shou University, Kaohsiung County, Taiwan, ROC.
Shih-Yuan
SY
Hung
Hung-Hsiang
HH
Liou
Luo-Ping
LP
Ger
Liang-Ken
LK
Chen
Mei-Chyn
MC
Liu
Hsiao-Min
HM
Chung
Kang-Ju
KJ
Chou
Tso-Hsiao
TH
Chen
Chih-Kuang
CK
Lin
Yu
Y
Yang
D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012307:Risk Factors; D013624:Taiwan