Predictive factors associated with the period of time before initiation of hemodialysis in CKD stages 4 and 5.
BACKGROUND
A majority of patients with chronic kidney disease (CKD) have cardiovascular disease at the initiation of dialysis therapy, suggesting that periodic echocardiographic examinations are important in such patients. The purpose of the present study was to evaluate the correlation between echocardiographic parameters and period of time before initiation of hemodialysis (iHD) in patients with CKD.


METHODS
140 patients with CKD stages 4 and 5 were enrolled. They were divided into diabetes and nondiabetes groups. Cardiac predictive parameters for the period of time before iHD were investigated in the patients using univariate and multivariate regression analyses.


RESULTS
In the nondiabetes group, systolic blood pressure (SBP) and left atrial volume index (LAVi) were identified as independent risk factors for the period of time before iHD by multivariate regression analysis. Serum albumin level was identified as an independent risk factor in the diabetes group. SBP, LAVi and serum albumin level were identified as independent risk factors in the combined diabetes and nondiabetes groups.


CONCLUSIONS
LAVi measurements during echocardiography, together with SBP and serum albumin levels, may be useful predictive factors for the period of time before iHD in patients with CKD stages 4 and 5.
Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.
Masako
M
Furukawa
Hiroaki
H
Io
Mitsuo
M
Tanimoto
Shinji
S
Hagiwara
Satoshi
S
Horikoshi
Yasuhiko
Y
Tomino
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000592:standards; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult