Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease
Abstract Introduction Excess body fluid, a prevalent complication in patients with end-stage kidney disease (ESKD), correlates with adverse outcomes. Whether higher vascular resistance, in the form of vascular calcification (VC), modulates the negative outcome influences posed by excess fluid remain...
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BMC
2025-07-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04942-y |
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| author | Chia-Ter Chao Min-Tser Liao Chung-Kuan Wu |
| author_facet | Chia-Ter Chao Min-Tser Liao Chung-Kuan Wu |
| author_sort | Chia-Ter Chao |
| collection | DOAJ |
| description | Abstract Introduction Excess body fluid, a prevalent complication in patients with end-stage kidney disease (ESKD), correlates with adverse outcomes. Whether higher vascular resistance, in the form of vascular calcification (VC), modulates the negative outcome influences posed by excess fluid remains unclear. We aimed to determine whether combination of inferior vena cava (IVCD) and VC, in the form of aortic arch calcification (AoAC) severity, influences the risk of adverse outcomes in ESKD patients. Methods We retrospectively analyzed enrolled chronic hemodialysis patients from a single center, dividing them according to IVCD and VC severity. After comparing their baseline clinical features, we analyzed the combined influences of IVCD and VC on ESKD patients’ risk of major adverse cardiovascular events (MACEs), cardiovascular and all-cause mortality over follow-up. Results Totally 227 ESKD patients were assigned to the non-to-mild VC/low IVCD (30.0%), non-to-mild VC/high IVCD (28.6%), mod-to-severe VC/low IVCD (23.3%), and mod-to-severe VC/high IVCD (18.1%) groups, respectively. After nearly 4 years follow-up, we showed the risk of MACEs was the highest among those with mod-to-severe VC and high IVCD (hazard ratio [HR]5.45,95% confidence interval [CI]2.33–12.75), followed by non-to-mild VC and high IVCD (HR 4.39,95% CI 1.93-10.00), and those with mod-to-severe VC and low IVCD (HR 3.91,95% CI 1.64–9.33), accounting for demographic, morbidities, laboratory, and medication variables. Similar trend was found on the risk of cardiovascular and all-cause mortality. Conclusions Fluid status and vascular resistance in the form of IVCD and VC additively worsened the cardiovascular outcome among ESKD patients. Cardiovascular care for ESKD patients should ideally encompass volume management and VC amelioration. |
| format | Article |
| id | doaj-art-23b13e135df44f75a4295a9cd407704e |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-23b13e135df44f75a4295a9cd407704e2025-08-20T03:03:20ZengBMCBMC Cardiovascular Disorders1471-22612025-07-0125111110.1186/s12872-025-04942-yInferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney diseaseChia-Ter Chao0Min-Tser Liao1Chung-Kuan Wu2Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of MedicineDepartment of Pediatrics, Taoyuan Armed Forces General HospitalDivision of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial HospitalAbstract Introduction Excess body fluid, a prevalent complication in patients with end-stage kidney disease (ESKD), correlates with adverse outcomes. Whether higher vascular resistance, in the form of vascular calcification (VC), modulates the negative outcome influences posed by excess fluid remains unclear. We aimed to determine whether combination of inferior vena cava (IVCD) and VC, in the form of aortic arch calcification (AoAC) severity, influences the risk of adverse outcomes in ESKD patients. Methods We retrospectively analyzed enrolled chronic hemodialysis patients from a single center, dividing them according to IVCD and VC severity. After comparing their baseline clinical features, we analyzed the combined influences of IVCD and VC on ESKD patients’ risk of major adverse cardiovascular events (MACEs), cardiovascular and all-cause mortality over follow-up. Results Totally 227 ESKD patients were assigned to the non-to-mild VC/low IVCD (30.0%), non-to-mild VC/high IVCD (28.6%), mod-to-severe VC/low IVCD (23.3%), and mod-to-severe VC/high IVCD (18.1%) groups, respectively. After nearly 4 years follow-up, we showed the risk of MACEs was the highest among those with mod-to-severe VC and high IVCD (hazard ratio [HR]5.45,95% confidence interval [CI]2.33–12.75), followed by non-to-mild VC and high IVCD (HR 4.39,95% CI 1.93-10.00), and those with mod-to-severe VC and low IVCD (HR 3.91,95% CI 1.64–9.33), accounting for demographic, morbidities, laboratory, and medication variables. Similar trend was found on the risk of cardiovascular and all-cause mortality. Conclusions Fluid status and vascular resistance in the form of IVCD and VC additively worsened the cardiovascular outcome among ESKD patients. Cardiovascular care for ESKD patients should ideally encompass volume management and VC amelioration.https://doi.org/10.1186/s12872-025-04942-yEchocardiographyEnd-stage kidney diseaseFluid statusVascular calcification |
| spellingShingle | Chia-Ter Chao Min-Tser Liao Chung-Kuan Wu Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease BMC Cardiovascular Disorders Echocardiography End-stage kidney disease Fluid status Vascular calcification |
| title | Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease |
| title_full | Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease |
| title_fullStr | Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease |
| title_full_unstemmed | Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease |
| title_short | Inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end-stage kidney disease |
| title_sort | inferior vena cava diameter and vascular calcification jointly influenced cardiovascular outcomes among patients with end stage kidney disease |
| topic | Echocardiography End-stage kidney disease Fluid status Vascular calcification |
| url | https://doi.org/10.1186/s12872-025-04942-y |
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