Risk Variants and Subclinical Cardiovascular Disease in Incident Hemodialysis Patients.

Introduction: To better understand the impact of risk variants in end-stage renal disease (ESRD) we evaluated associations of risk variants with subclinical cardiovascular disease (CVD) and mortality among African Americans initiating hemodialysis and enrolled in the Predictors of Arrhythmic and Cardiovascular Risk in ESRD cohort study.

Methods: We modeled associations of risk status (high = 2; low = 0/1 risk alleles) with baseline subclinical CVD (left ventricular [LV] hypertrophy; LV mass; ejection fraction; coronary artery calcification [CAC]; pulse wave velocity [PWV]) using logistic and linear regression and all-cause or cardiovascular mortality using Cox models, adjusting for age, sex, and ancestry. In sensitivity analyses, we further adjusted for systolic blood pressure and Charlson Comorbidity Index.

Results: Of 267 African American participants successfully genotyped for , 27% were high-risk carriers, 41% were women, and mean age was 53 years. At baseline, high- versus low-risk status was independently associated with 50% and 53% lower odds of LV hypertrophy and CAC, respectively, and 10.7% lower LV mass. These associations were robust to further adjustment for comorbidities but not systolic blood pressure. risk status was not associated with all-cause or cardiovascular mortality (mean follow-up 2.5 years).

Conclusion: Among African American patients with incident hemodialysis, high-risk status was associated with better subclinical measures of CVD but not mortality.