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Ito K, Ookawara S, Ueda Y, et al. A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation. Nephron Extra. 2015;5(3):100-10doi: 10.1159/000442591.
Ito, K., Ookawara, S., Ueda, Y., Miyazawa, H., Yamada, H., Goto, S., Ishii, H., Shindo, M., Kitano, T., Hirai, K., Yoshida, M., Kaku, Y., Hoshino, T., Nabata, A., Mori, H., Yoshida, I., Kakei, M., Morishita, Y., & Tabei, K. (2015). A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation. Nephron extra, 5(3), 100-10. https://doi.org/10.1159/000442591
Ito, Kiyonori, et al. "A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation." Nephron extra vol. 5,3 (2015): 100-10. doi: https://doi.org/10.1159/000442591
Ito K, Ookawara S, Ueda Y, Miyazawa H, Yamada H, Goto S, Ishii H, Shindo M, Kitano T, Hirai K, Yoshida M, Kaku Y, Hoshino T, Nabata A, Mori H, Yoshida I, Kakei M, Morishita Y, Tabei K. A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation. Nephron Extra. 2015 Dec 19;5(3):100-10. doi: 10.1159/000442591. eCollection 2015. PMID: 26951636; PMCID: PMC4777940.
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Nephron Extra. 2015 Dec 19;5(3):100-10. doi: 10.1159/000442591. eCollection 2015.

A Higher Cardiothoracic Ratio Is Associated with 2-Year Mortality after Hemodialysis Initiation.

Nephron extra

Kiyonori Ito, Susumu Ookawara, Yuichiro Ueda, Haruhisa Miyazawa, Hodaka Yamada, Sawako Goto, Hiroki Ishii, Mitsutoshi Shindo, Taisuke Kitano, Keiji Hirai, Masashi Yoshida, Yoshio Kaku, Taro Hoshino, Aoi Nabata, Honami Mori, Izumi Yoshida, Masafumi Kakei, Yoshiyuki Morishita, Kaoru Tabei

Affiliations

  1. Divisions of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
  2. Endocrinology and Metabolism, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
  3. Division of Clinical Nephrology and Rheumatology, Niigata University Medical and Dental Hospital, Japan.
  4. Usui Hospital, Annaka, Japan.
  5. Divisions of Nephrology, Saitama Medical Center, Jichi Medical University, Saitama, Japan; Minami-Uonuma City Hospital, Niigata, Japan.

PMID: 26951636 PMCID: PMC4777940 DOI: 10.1159/000442591

Abstract

UNLABELLED: A high cardiothoracic ratio (CTR) is indicative of a cardiac disorder. However, few reports have revealed an association between the CTR and mortality in patients starting hemodialysis (HD).

METHODS: Patients with HD initiation (n = 387; mean age, 66.7 ± 12.7 years) were divided into the following three groups according to their CTR at HD initiation: CTR <50%, 50% ≤ CTR < 55%, and CTR ≥55%. Kaplan-Meier analysis was performed to compare 2-year all-cause mortality among these groups. Furthermore, we investigated the factors affecting their 2-year mortality using a Cox proportional hazard regression analysis.

RESULTS: Sixty-five patients (17%) died within 2 years after HD initiation. Kaplan-Meier analysis showed that patients with CTR ≥55% had a higher mortality rate than those in the other groups. Cox proportional hazard regression analysis was performed using parameters with p values <0.1 among these three groups [sex, age, presence or absence of ischemic heart disease, hemoglobin levels, serum albumin levels, CTR, body mass index (BMI)] and confounding factors [presence or absence of diabetes mellitus, and estimated glomerular filtration rate (eGFR)]. Age, eGFR, BMI, and CTR ≥55% at HD initiation were identified as factors influencing 2-year mortality.

CONCLUSION: CTR >55% is one of the most important independent factors to affect 2-year all-cause mortality. Thus, confirming the cardiac condition of patients at HD initiation with a CTR >55% may improve their survival.

Keywords: Cardiothoracic ratio; Diabetes mellitus; Hemodialysis; Ischemic heart disease; Mortality

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