Association between serum aluminum levels and cardiothoracic ratio in patients on chronic hemodialysis

The cardiothoracic ratio (CTR) and serum aluminum levels are both associated with mortality in hemodialysis patients. However, limited data regarding the association between serum aluminum levels and the CTR have been published to date. Therefore, we aimed to elucidate this association in patients o...

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Bibliographic Details
Published in:PloS one 2017-12, Vol.12 (12), p.e0190008-e0190008
Main Authors: Wang, Tzu-Lin, Fang, Yu-Wei, Leu, Jyh-Gang, Tsai, Ming-Hsien
Format: Article
Language:English
Subjects:
Aluminum
Aluminum alloys
Analysis
Biology and Life Sciences
Confidence intervals
Diabetes
Diabetes mellitus
Dialysis
Generalized linear models
Genetic aspects
Health care
Heart
Heart diseases
Hemodialysis
Hospitals
Internal medicine
Kidney diseases
Laboratories
Medicine and Health Sciences
Nephrology
Normal distribution
Patients
Physical Sciences
Preventive medicine
Risk factors
Transformation
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Summary:The cardiothoracic ratio (CTR) and serum aluminum levels are both associated with mortality in hemodialysis patients. However, limited data regarding the association between serum aluminum levels and the CTR have been published to date. Therefore, we aimed to elucidate this association in patients on chronic hemodialysis (CHD). We investigated the association between the serum aluminum level and the CTR in CHD in a retrospective cross-sectional study of 547 Taiwanese patients on CHD. The mean age of patients was 62.5±13.2 years, with a mean hemodialysis time of 7.1±5.2 years. Among the patients, 36.9% were diabetic and 47.9% were male. After natural logarithmic transformation (ln(aluminum)), the serum aluminum level exhibited an independent and linear relationship with the CTR (β: 1.40, 95% confidence interval (CI), 0.6-2.2). A high serum aluminum level (≥6 ng/dL) was significantly associated with a CTR >0.5 in the crude analysis (odds ratio (OR): 2.15, 95% CI, 1.52-3.04) and remained significant after multivariable adjustment (OR: 2.45, 95% CI, 1.63-3.67). Moreover, the ln(aluminum) value was significantly associated with a CTR >0.5 (OR: 1.71, 95%CI, 1.28-2.29) in multivariable analysis, indicating a dose effect of aluminum on cardiomegaly. In conclusion, the serum aluminum level was independently associated with cardiac remodeling (elevated CTR) in patients on CHD.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0190008