Interdialytic Weight Gain and Cardiovascular Outcome in Incident Hemodialysis Patients

Abstract

Background: Interdialytic weight gain (IDWG) has been regarded as a surrogate of volume overload, but also as a marker of a better nutritional status in end-stage renal disease (ESRD) patients on hemodialysis (HD). This paradoxical meaning of IDWG requires further investigation, particularly in adverse cardiovascular outcomes. Methods: A prospective cohort of 1,013 incident HD patients from 36 HD centers of the Clinical Research Center for ESRD in Korea was included. Patients were categorized into five groups according to the IDWG%, a ratio of absolute IDWG to dry weight: <1.0, ≥ 4.0, and every 1.0 increment in between. Primary outcome was major adverse cardiac and cerebrovascular events (MACCE). Results: During a mean follow-up of 18.7 months, primary outcome was observed in 104 patients (10.3%). In multivariate analysis, compared to patients with IDWG% of Received: February 7, 2014 Accepted: April 3, 2014 Published online: May 10, 2014 Nephrology American Journal of Shin-Wook Kang, MD, PhD Department of Internal Medicine, College of Medicine Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752 (Korea) E-Mail kswkidney @ yuhs.ac © 2014 S. Karger AG, Basel 0250–8095/14/0395–0427$39.50/0