Validation of biomarkers for risk of cardiovascular diseases in hemodialysis patients

Abstract

Background and aim: Worldwide the number of patients requiring hemodialysis is rapidly growing in order to treat end-stage renal disease (ESRD). Kidney diseases greatly reduce quality of life and are associated with extremely high mortality rates. The present study was planned to study the impact of age and gender on cardiovascular death markers in a sample of ESRD Egyptian patients, maintained on hemodialysis. Subjects and methods: In an observational cohort study, 70 non-diabetic patients on maintenance hemodialysis (MHD) were investigated. All patients were non-diabetics without viral hepatitis, with mean age of 57±7.3. Patients were divided into subgroups according to gender, age (age was dichotomized as < or ≥ 60 years), and rate of mortality. Fifteen matching controls were included for reference values. All subjects underwent blood analyses before the commencement of hemodialysis, and echocardiography during follow-up. Patients were followed for 4 years, and cardiovascular mortality rate was recorded. Results: A total of 45 patients died (64.3%), all of them suffered from cardiovascular complications. The first echocardiographic examination and rate of mortality did not differ among the subgroups. Although the overall relative risk of cardiovascular mortality was equivalent between men and women, age had a significant interaction with gender on the overall biochemical markers. Compared with patients who survived, women who died and were younger than 60 years old had lower albumin and higher globulin serum levels. However, diseased women older than 60 years had lower urea and high-sensitive C-reactive protein (Hs CRP), together with higher LDL, LDL/HDL ratio, and bone-specific alkaline phosphatase (B-ALP) activity. These differences were not recorded in male patients.