Echocardiographic Parameters as Cardiovascular Mortality Predictors in Chronic Hemodialysis Patients

Background: Hemodialysis (HD) patients have high rates of cardiovascular (CV) mortality. Although structural and functional echocardiographic alterations in HD patients have been the subject of several survival analysis studies, the prognostic value of these alterations is not well established. The aim of this study was to determine the prognostic value of echocardiographic parameters in chronic HD patients. Objectives: One hundred eighteen HD patients were clinically evaluated and underwent Doppler echocardiography, being followed for 45.7 ± 13.6 months. The outcome measures were CV mortality. The predictive value of echocardiographic variables was evaluated by Cox regression model and survival curves were constructed using the Kaplan-Meier method and log-rank test to compare them. Results: CV diseases accounted for 46.4% of all deaths during the follow-up period. We found that the event-free survival rates in one and two years were 96.5% and 83.0%, respectively. Diabetes and E/e' ratio were predictors of CV outcome by multivariate analyses. Conclusion: Diabetes and diastolic dysfunction are independent predictors of CV mortality in chronic HD patients.