P1.06 CARDIO-ANKLE VASCULAR INDEX (CAVI) IS AN INDEPENDENT PREDICTOR OF DEATH IN MAINTENANCE HEMODIALYSIS PATIENTS

Abstract

Objects: The purpose of this study was to calculate robust quantitative estimates of the predictive value of cardio-ankle vascular index, (CAVI) for future all-cause mortality in hemodialysis patients. Subjects and methods: A total of 163 hemodialysis patients (102 males and 61 females, mean age 60±11 years), who had the examination of CAVI between 2004 and 2005 at Mihama Narita Clinic, Chiba, Japan, were included and followed up for 80 months. Those had diabetes mellitus (27.0%), hypertension (77.3%) or/and dyslipidemia (36.8%). CAVI was measured using Vasela1500 (Fukuda Denshi. Co.LTD). Results: Among 163 hemodialysis patients, 51 deaths were observed in 6.5 years. Causes of death were heart disease (37.3%), brain stroke (19.6%), infection (17.6%), suffocation (3.9%) and others. In subjects with death, higher CAVI (9.3±1.8 vs. 8.3±1.2), mean age (65±12 vs. 57±10 years) and prevalence of diabetic nephropathy (43.1 vs. 19.6%) were observed. COX proportional-hazards regression analysis of the association between death and clinical variables showed that high CAVI (≥10) independently increased the risk of death with OR of 2.605 (95% CI 1.321–5.141, P=0.006). OR of Diabetic nephropathy was 2.027(95%CI 1.102–3.727, P=0.023) and OR of elderly (≥65 years) was 3,152, (95%CI 1.758–5.649, P<0.0001). Kaplan-Meier curves for cumulative survival in hemodialysis patients stratified by severity of CAVI(8>, 9>,10>, 10<) showed that the survival rates on the patients with higher CAVI groups were significantly low (P=0.002, Log-rank test). Conclusion: CAVI is an independent predictor of death in hemodialysis patients.