Clinical Characteristics and Risk Factors for Major Adverse Cardiovascular Events in Patients on Maintenance Hemodialysis: A Retrospective Study

Objective: Patients on maintenance hemodialysis face a disproportionately high burden of cardiovascular disease, with major adverse cardiovascular events being the leading cause of death. However, the relative importance and specific roles of traditional versus non-traditional risk factors in this unique population require further elucidation in clinical practice. This study aimed to investigate the risk factors for major adverse cardiovascular events in patients undergoing maintenance hemodialysis, thereby providing evidence for clinical risk stratification and early intervention. Methods: A single-center retrospective study was carried out, enrolling 196 patients with end-stage renal disease who received regular MHD (duration ≥ 6 months) between January 2021 and August 2022. According to MACE occurrence during follow-up, patients were categorized into MACE (n = 66) and non-MACE (n = 130) groups. Baseline characteristics, comorbidities, and laboratory parameters were collected. Logistic regression analysis was utilized to assess independent risk factors for MACEs, and their predictive value was evaluated using receiver operating characteristic (ROC) curve analysis. Results: Over a 21-month follow-up, the cumulative MACE incidence was 33.67%. Multivariate analysis revealed that serum albumin was an independent protective factor for MACEs (OR = 0.679, 95% CI: 0.558– 0.827, P < 0.01), whereas C-reactive protein (CRP) was an independent risk factor (OR = 1.151, 95% CI: 0.994– 1.334, P = 0.046). ROC curve analysis demonstrated that the combination of serum albumin and CRP provided the best predictive performance, with an area under the curve (AUC) of 0.7224 (sensitivity 81.77%, specificity 51.52%). Conclusion: Low serum albumin and elevated CRP are independent risk factors for MACEs in MHD patients. The combined assessment of these two biomarkers offers good predictive value for MACEs and may serve as an effective tool for clinical screening of high-risk patients.