Key result
Moderate-to-severe hepatic dysfunction in dialysis patients linked to ~114% greater CAD risk.
Why the study?
Hepatic dysfunction is frequent in ESRD patients on maintenance dialysis and may introduce metabolic and inflammatory disturbances influencing cardiovascular outcomes, but CAD prevalence and predictors in this group needed assessment.
Observational (n=369)
No
Effect estimate: AOR 2.14 (95% CI 1.31-3.48)
p-value: p=0.002
In ESRD patients on maintenance hemodialysis, concurrent hepatic dysfunction significantly amplifies the risk of coronary artery disease, highlighting the need for aggressive cardiovascular risk stratification in this dual-organ impairment population.
May warrant aggressive CV risk stratification in ESRD with hepatic dysfunction; extends independent CAD predictors in dialysis.
Background: Patients with end-stage renal disease (ESRD) undergoing maintenance dialysis are at markedly increased risk of coronary artery disease (CAD). The presence of hepatic dysfunction is frequently observed in this population and may be associated with additional metabolic and inflammatory disturbances that influence cardiovascular outcomes. Objective: This study assessed the prevalence of CAD and identified its significant predictors among ESRD patients with concurrent hepatic impairment. Methods: A retrospective observational study was conducted at Mayo Hospital, Lahore, from August 2024 to August 2025, reviewing medical records of 369 ESRD patients undergoing maintenance hemodialysis with documented hepatic dysfunction. Demographic characteristics, comorbidities, dialysis-related parameters, laboratory findings, and hepatic profiles were extracted. Hepatic dysfunction severity was classified using the Child-Pugh system. CAD was diagnosed based on ≥50% coronary artery stenosis on angiography, regional wall motion abnormalities on echocardiography suggestive of ischemia, or positive noninvasive ischemia testing. Results: The mean age of the participants was 57.8 ± 11.6 years, and 58.5% were male. The overall prevalence of CAD was 38.7% (n = 143). Among CAD-positive patients, 59 (41.3%) had angiographic stenosis ≥50%, 48 (33.6%) demonstrated regional wall motion abnormalities on echocardiography, and 36 (25.2%) had positive noninvasive ischemia tests. Patients with CAD were significantly older (61.2 ± 10.7 vs. 55.9 ± 11.8 years, p < 0.001) and had a higher prevalence of diabetes mellitus and dyslipidemia. Dialysis duration was longer in CAD-positive patients (4.9 ± 2.4 vs. 3.8 ± 1.9 years, p < 0.001). Multivariable regression analysis identified older age (AOR 1.04, 95% CI 1.02-1.07), diabetes mellitus (AOR 1.89, 95% CI 1.20-2.98), prolonged dialysis duration (AOR 1.28, 95% CI 1.12-1.46), elevated CRP (AOR 1.75, 95% CI 1.08-2.84), and moderate-to-severe hepatic dysfunction (AOR 2.14, 95% CI 1.31-3.48) as independent predictors of CAD, while albumin demonstrated a protective association (AOR 0.72, 95% CI 0.54-0.96). Conclusion: CAD is highly prevalent among ESRD patients undergoing maintenance dialysis with concurrent hepatic dysfunction. Age, diabetes mellitus, dialysis duration, systemic inflammation, and severity of hepatic impairment significantly contribute to CAD risk in this population.
No takes yet. Share an insight, caveat, or question.
Chandio et al. (2026) conducted an observational in End-Stage Renal Disease (ESRD) on maintenance hemodialysis with hepatic dysfunction (n=369). Coronary artery disease was present in 38.7% of ESRD patients on dialysis, with moderate-to-severe hepatic dysfunction independently increasing the risk of CAD by over twofold (AOR 2.14).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: