title: Predictive value of echocardiography and its relation to Kt/V and anthropometric parameters in hemodialysis patients.
abstract: BACKGROUND
  In order to evaluate the predictive value of echocardiograph parameters for mortality of hemodialysis patients and their relation to Kt/V and anthropometry, a prospective, single center study was analyzed post-hoc.
  
  
  METHODS
  This analysis encompassed 106 patients on maintenance hemodialysis monitored for 108 months from 1996 to 2004. spKt/V was calculated using the Daugirdas formula. Anthropometric measurements included mid-arm muscle measurements (MAMC) and percentage of body fat (%fat). Echocardiography included the estimations of left ventricular wall thickness, dimensions and volumes (EDV, ESV), systolic LV function (ejection fraction - EFLV, fractional shortening - VCF, stroke volume - SV) and diastolic LV function (E/A, VTI-A wave of transmitral flow velocity), left atrial diameter, as well as assessment of clinical and biochemical parameters. The Cox proportional hazard model was used to estimate predictive values of echocardiograph parameters.
  
  
  RESULTS
  Kt/V correlated significantly with left ventricular systolic and diastolic volumes and function, septal and posterior wall thickness and left atrium dimension. MAMC and %fat also correlated with many echocardiograph parameters. Multivariate Cox regression selected age [HR 1.07; CI (1.03-1.12); p < 0.01], albumin [HR 0.88; CI (0.79-0.97); p < 0.05] and left atrium dimension - binary [values > 4 cm were marked as "1" and others "0" - HR 3.76; CI (1.56-9.03); p < 0.01] as independent predictors of death.
  
  
  CONCLUSIONS
  Left atrium dimension was the most important predictor of mortality among the echocardiograph parameters. Many of these parameters were related to Kt/V and anthropometric measurements and could be the combined consequence of hypervolemia and hypertension.
authors: Clinic of Nephrology, Clinical Center of Serbia , Beograd , Serbia .
authors: Milan D
authors: MD
authors: Stosovic
authors: Milan Z
authors: MZ
authors: Petrovic
authors: Bosiljka D
authors: BD
authors: Vujisic-Tesic
authors: Mirjana Lj
authors: MLj
authors: Stanojevic
authors: Sanja P
authors: SP
authors: Simic-Ogrizovic
authors: Dijana B
authors: DB
authors: Jovanovic
authors: Radomir T
authors: RT
authors: Naumovic
mesh_terms: D001837:Body Weights and Measures; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000378:metabolism / Q000628:therapy*
keywords: Adequacy; Kt/V; anthropometry; hemodialysis; nutrition; retrospective study; survival analysis