A Low Serum Albumin Level Predicts Cardiovascular Events in Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

Abstract

Background: Cardiovascular (CV) diseases are the most frequent cause of death in hemodialysis (HD) patients. The aim of this study was to identify risk factors for CV events in HD patients with preserved left ventricular ejection fraction (PEF). Objectives: A total of 213 HD patients (69 years, 64.1% males) were enrolled. Demographic, laboratory test, and echocardiographic data were recorded, and CV events during the 32-month follow-up period were documented. Results: During the follow-up period, 31 patients (14.6%) died and 50 patients (23.5%) suffered a fatal or nonfatal CV event. Age and serum albumin, C-reactive protein, total cholesterol, non-HDL cholesterol, and NT-proBNP levels were associated with CV events according to a univariate analyses. A multivariate analysis identified a low serum albumin value (p < 0.001) as an independent predictor of CV events. A low serum albumin level was also identified as an independent predictor of all-cause mortality (p = 0.0356). Kaplan-Meier curves showed CV events to be more frequent in the group of subjects with the lowest tertile of serum albumin levels (p = 0.0063). Conclusion: A low serum albumin value is an important risk factor for death and CV events in HD patients with PEF.