Relationship between ultrafiltration rate and cardiovascular death in maintenance hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To investigate the relationship between ultrafiltration rate (UFR) and cardiovascular death in maintenance hemodialysis patients.Methods This retrospective study observed adult hemodialysis patients treated in Kidney Disease Center,the First Affiliated Hospital,College of Medicine,Zhejiang University during January 2010 to December 2015 and the follow-up were finished at April 2017.Patients were averagely divided into 3 groups according to their UFR.Their clinic characteristics were collected,the survival rate and death related factors were analyzed by Kaplan-Meier (Log-rank test) method and Logistic regression.Results Totally 2184 patients (male 1370,62.7％) were enrolled,the age was 53.39±16.47.The UFR was (8.88±3.05) ml·h-1· kg-1.During the 7 years’ follow-up,168 patients died,of whom 58 cases (34.5％) died due to the cardiovascular events.Chi-square test showed that there were significant differences in death causes among the high,middle and low UFR group (x2=12.584,P ＜ 0.01),and the mortality rate of cardiovascular events in high UFR group was significantly higher than that in low (x2=10.861,P=0.010) and middle UFR group (x2=4.671,P=0.031).Kaplan-Meier survival curve showed that the difference of the survival rates in the 3 groups was statistically significant (Log-rank test x2=23.394,P ＜ 0.001).Cox regression analysis showed that high UFR (UFR≥10.95 ml· h-1· kg-1),old age (＞ 60 years old),and low left ventricular ejection fraction (LVEF,≤50％ were independent risk factors of cardiovascular death.Conclusions High UFR level,old age and low LVEF are independent risk factors of cardiovascular death in hemodialysis patients.Maintaining low UFR level is beneficial to reduce cardiovascular mortality in hemodialysis patients.