Central blood volume and cardiac output index predict all-cause and cardiovascular mortality in chronic hemodialysis patients.

BACKGROUND

This study investigated the effect of central blood volume (CBV) and cardiac output index (COI) on the all-cause and cardiovascular mortality in chronic hemodialysis (CHD) patients.

MATERIALS AND

METHODS

Adult CHD patients with functional arteriovenous access at the hemodialysis center of a medical center between January 1, 2003, and December 31, 2014, were recruited in this retrospective observational study. The primary and secondary endpoints were all-cause and cardiovascular mortality. Cumulative incidences of all-cause and cardiovascular mortality during the follow-up period were estimated and compared using the Kaplan-Meier method and log-rank test. Logistic regression and Cox proportional hazards models were used to calculate odds and hazard ratios.

RESULTS

A total of 390 CHD patients were enrolled, including 34 patients with early mortality. The early mortality group had a higher CBV than the survival group. CBV and COI were independently associated with all-cause and cardiovascular mortality. Low COI (< 3 L/min/m2) and high CBV (≥ 1.25 L) independently predicted long-term all-cause and cardiovascular mortality. The highest risks of all-cause and cardiovascular mortality were observed in patients with low COI and high CBV, followed by high COI and high CBV and then low COI and low CBV. Mortality was the lowest in those with high COI and low CBV.

CONCLUSION

CBV and COI are important factors for predicting death in CHD patients. Those with low COI and high CBV had the worst outcomes.