Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease

Abstract Background Pericardial effusion (PE) is common in patients with end-stage renal disease (ESRD) undergoing maintenance haemodialysis (MHD). The prognostic value of a small, haemodynamically non-compromising PE in patients with ESRD who undergo MHD, is currently lacking. Objective The purpose...

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Main Authors: Lizheng Song, Jian Chen, Junwei Xu, Liyun Luo, Mei Xu, Wenyi Tang, Yuxi Huang, Hsi Huang, Man Li, Jianting Ke
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04233-w
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author Lizheng Song
Jian Chen
Junwei Xu
Liyun Luo
Mei Xu
Wenyi Tang
Yuxi Huang
Hsi Huang
Man Li
Jianting Ke
author_facet Lizheng Song
Jian Chen
Junwei Xu
Liyun Luo
Mei Xu
Wenyi Tang
Yuxi Huang
Hsi Huang
Man Li
Jianting Ke
author_sort Lizheng Song
collection DOAJ
description Abstract Background Pericardial effusion (PE) is common in patients with end-stage renal disease (ESRD) undergoing maintenance haemodialysis (MHD). The prognostic value of a small, haemodynamically non-compromising PE in patients with ESRD who undergo MHD, is currently lacking. Objective The purpose of this study was to determine the predictive significance of a small, haemodynamically non-compromising PE in MHD patients with ESRD. Methods and results Patients with ESRD who received regular dialysis in the Hemodialysis Center of the Fifth Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2020 were retrospectively analyzed. A total of 352 patients with ESRD receiving MHD were enrolled in this study, including 82 patients with PE and 270 patients without PE. The overall median follow-up time was 2.4 years. Compared to the non-PE group, the mortality rate was higher in the PE group (31.7% vs. 18.5%; P = 0.011). PE was associated with an increased all-cause mortality. The Cox proportional hazard model showed that PE was the risk factor for all-cause death (HR: 1.964; 95%CI: 1.020–3.784; P = 0.044), as well as age (HR: 1.049; 95%CI: 1.022–1.076; P = 0.001), diabetes (HR: 2.404; 95%CI: 1.226–4.713; P = 0.011), hemoglobin (HR: 0.983; 95%CI: 0.969–0.997; P = 0.020) and ultrafiltration rate (HR: 1.082; 95%CI: 1.015–1.153; P = 0.015). Echocardiographic follow-up results showed that the mortality rate in the PE persistence group was significantly higher than that in the PE regression group (44.1% vs. 20.7%, P = 0.049). Conclusion In MHD patients with ESRD, even haemodynamically irrelevant PE is associated with an increased risk of all-cause mortality. Clinical trial number Not applicable.
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spelling doaj-art-22f4244f41df4812a67ee2f5c8452e012025-08-20T03:45:22ZengBMCBMC Nephrology1471-23692025-07-012611910.1186/s12882-025-04233-wHaemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal diseaseLizheng Song0Jian Chen1Junwei Xu2Liyun Luo3Mei Xu4Wenyi Tang5Yuxi Huang6Hsi Huang7Man Li8Jianting Ke9Department of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Shenzhen Nanshan People’s Hospital and The 6th Affiliated Hospital of Shenzhen University Medical SchoolDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen UniversityDepartment of Cardiovascular Medicine, Fifth Affiliated Hospital of Sun Yat-sen UniversityAbstract Background Pericardial effusion (PE) is common in patients with end-stage renal disease (ESRD) undergoing maintenance haemodialysis (MHD). The prognostic value of a small, haemodynamically non-compromising PE in patients with ESRD who undergo MHD, is currently lacking. Objective The purpose of this study was to determine the predictive significance of a small, haemodynamically non-compromising PE in MHD patients with ESRD. Methods and results Patients with ESRD who received regular dialysis in the Hemodialysis Center of the Fifth Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2020 were retrospectively analyzed. A total of 352 patients with ESRD receiving MHD were enrolled in this study, including 82 patients with PE and 270 patients without PE. The overall median follow-up time was 2.4 years. Compared to the non-PE group, the mortality rate was higher in the PE group (31.7% vs. 18.5%; P = 0.011). PE was associated with an increased all-cause mortality. The Cox proportional hazard model showed that PE was the risk factor for all-cause death (HR: 1.964; 95%CI: 1.020–3.784; P = 0.044), as well as age (HR: 1.049; 95%CI: 1.022–1.076; P = 0.001), diabetes (HR: 2.404; 95%CI: 1.226–4.713; P = 0.011), hemoglobin (HR: 0.983; 95%CI: 0.969–0.997; P = 0.020) and ultrafiltration rate (HR: 1.082; 95%CI: 1.015–1.153; P = 0.015). Echocardiographic follow-up results showed that the mortality rate in the PE persistence group was significantly higher than that in the PE regression group (44.1% vs. 20.7%, P = 0.049). Conclusion In MHD patients with ESRD, even haemodynamically irrelevant PE is associated with an increased risk of all-cause mortality. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04233-wEnd-stage renal diseaseHemodialysisPericardial effusionAll-cause deathCardiac death
spellingShingle Lizheng Song
Jian Chen
Junwei Xu
Liyun Luo
Mei Xu
Wenyi Tang
Yuxi Huang
Hsi Huang
Man Li
Jianting Ke
Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
BMC Nephrology
End-stage renal disease
Hemodialysis
Pericardial effusion
All-cause death
Cardiac death
title Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
title_full Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
title_fullStr Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
title_full_unstemmed Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
title_short Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease
title_sort haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end stage renal disease
topic End-stage renal disease
Hemodialysis
Pericardial effusion
All-cause death
Cardiac death
url https://doi.org/10.1186/s12882-025-04233-w
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