Heart Fat Predicts Dialysis Patient Mortality

Increasing epicardial adipose tissue (EAT) is associated with greater mortality risk among incident hemodialysis (HD) patients, a new study suggests.

A team led by Paolo Raggi, MD, Director, Mazankowski Alberta Heart Institute and Professor of Medicine, University of Alberta Capital Health Chair in Cardiac Research, studied 95 incident HD patients who participated in the randomized Renagel in New Dialysis (RIND) patients study and who had available baseline EAT measurements as determined by computed tomography. During a median follow-up period of 49.3 months, 27 patients (28.4%) died. The five-year survival rate was 44.6% for patients with EAT above the median value compared with 71,2% for those with EAT above the median, Dr. Raggi and his colleagues reported online ahead of print in Nephrology Dialysis Transplantation. Each 10 cc increment in EAT was associated with a significant 6% increase in death risk. Results also showed that coronary artery calcification and age were significantly associated with all-cause mortality.

Although the extent of EAT has been associated with the presence of subclinical atherosclerosis and adverse outcomes in the general population, the authors noted, their published findings are the first report on the prognostic impact of EAT in patients with stage 5 chronic kidney disease.

Due to the ease with which EAT is measured, it may become a useful method to assess the risk noninvasively in CKD patients, a population with extremely high rates of cardiovascular diseases.

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