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      Cardiothoracic Ratio, Malnutrition, Inflammation, and Two-Year Mortality in Non-Diabetic Patients on Maintenance Hemodialysis

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          Abstract

          Background/Aims: Cardiothoracic ratio (CTR) is associated with left ventricular mass, left ventricular systolic dysfunction and mortality in patients with hypertension or chronic cardiovascular disease. The clinical significance of CTR in non-diabetic maintenance hemodialysis (MHD) patients remains unclear. Methods: 468 non-diabetic MHD patients were enrolled. Geographic, hematological, biochemical and dialysis-related data were obtained. The patients were analyzed for nutritional and inflammatory markers as well as CTR. All patients were followed up for 2 years to investigate the risks for mortality. Results: Chi-square analysis showed that the incidence of malnutrition and inflammation was significantly higher in patients with CTR >60% than in patients with CTR ≤60%. CTR positively correlated with high-sensitivity C-reactive protein (hsCRP) levels but negatively correlated with albumin levels. 29 patients (6.2%) had expired by the end of the study. Cox multivariate analysis revealed that CTR significantly predicts both all-cause and cardiovascular-cause 2-year mortality in non-diabetic MHD patients. Conclusion: CTR is an indicator of inflammation and nutritional status in non-diabetic MHD patients and can predict 2-year mortality in these patients. The analytical results of this study support continued efforts to reduce CTR and treat underlying causes in patients with CTR >50%.

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          Most cited references 25

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                Author and article information

                Journal
                KBR
                Kidney Blood Press Res
                10.1159/issn.1420-4096
                Kidney and Blood Pressure Research
                S. Karger AG
                1420-4096
                1423-0143
                2008
                July 2008
                21 April 2008
                : 31
                : 3
                : 143-151
                Affiliations
                Department of Nephrology, Chang Gung Memorial Hospital, and Chang Gung University, School of Medicine, Taoyuan, Taiwan, ROC
                Article
                127388 Kidney Blood Press Res 2008;31:143–151
                10.1159/000127388
                18424899
                © 2008 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 9, References: 34, Pages: 9
                Categories
                Original Paper

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