Effect of Interdialytic Weight Gain on Cardiovascular Mortality and Morbidity
Abstract
Objective: Compared to the general population, chronic kidney disease (CKD) is associated with high mortality and morbidity. Cardiovascular diseases (CVD) are prevalent among CKD patients and are the most common cause of mortality. One of the most critical factors affecting CKD patients’ mortality is
fluid and electrolyte balance. Our study aimed to determine the effects of interdialytic weight gain (IDWG) on cardiovascular (CV) mortality and morbidity in hemodialysis patients and examine its relationship with nutritional parameters.
Material and Methods: We retrospectively analyzed the hospital records of 111 hemodialysis patients. Mortality developed in 17 patients during the 2-year follow-up. The dry weight of the patients was calculated according to clinical findings. While evaluating dry weight, edema indicating fluid overload, high blood pressure, and cardiothoracic index on chest X-ray were examined. Post-dialysis weight, in which patients remained normotensive, was considered dry weight. Interdialytic weight gain was calculated as the difference between pre-dialysis and post-dialysis dry weights. IDWG values of the patients at 0-6-12-18 and 24 months were recorded. Echocardiographic evaluations made by the same person were obtained from the files of the patients.
Results: Mortality developed in 17 patients at two-year follow-up. IDWG rates between mortality and non-mortality group were %3.84 and %3.67 respectively (p=0.644). In our study mortality rate in the higher IDWG group was %27 (5/18) and %12 (12/93) in the lower IDWG group. In the mortality group, mean
systolic and diastolic blood pressures were 125 mmHg and 75,8 mmHg, respectively. In the non-mortality group, mean systolic and diastolic blood pressures were 125 mmHg and 79 mmHg, respectively (systolic blood pressure p=0.961, diastolic blood pressure p=0.825).
Conclusion: In our study, the factors that affect mortality were diabetes mellitus, Ejection fraction (EF), and advanced age. When hemodialysis patients are evaluated regarding age, comorbidity, and mortality, follow-up and appropriate treatment may cause beneficial outcomes.
Keywords
References
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