High Interdialytic Weight Gain and LVH Predict Adverse Cardiovascular Outcomes in dialysis patients: Study

A new study published in the journal of Cureus that interdialytic weight gain greater than 3 kg and left ventricular hypertrophy (LVH) were identified as key predictors of adverse outcomes among dialysis patients.

Cardiovascular disease (CVD) remains the leading cause of illness and death among people with chronic kidney disease (CKD) who require long-term dialysis. While doctors have long known that these patients face higher heart risks, this research looks on how interdialytic weight gain (IDWG) plays a major role in triggering serious cardiovascular events.

The prospective cohort study followed 100 CKD patients undergoing MHD for 18 months. This research closely tracked cardiovascular outcomes like myocardial infarction, sudden cardiac death, atrial fibrillation, and cerebrovascular accidents. At every dialysis visit, patients’ weight was recorded to calculate their IDWG, and these values were compared against the occurrence of heart-related events and overall survival.

Nearly one in 4 patients (23%) experienced at least one cardiovascular event during the follow-up period. The most common problems included heart attacks, abnormal heart rhythms, strokes, and sudden cardiac deaths. Overall mortality stood at 16%, with most deaths linked directly to cardiovascular causes, underscoring how vulnerable dialysis patients are to heart disease.

Three key risk factors emerged strongly from the analysis: hypertension, left ventricular hypertrophy and excessive IDWG. Patients who gained more than 3 kilograms between dialysis sessions were significantly more likely to suffer cardiovascular complications than those who maintained lower weight gains. LVH showed the strongest association, indicating that structural changes in the heart markedly worsen outcomes in this group.

The study demonstrated that patients with hypertension had a significantly higher rate of heart events than those with normal blood pressure. Similarly, individuals with LVH were far more prone to developing major cardiovascular complications. When IDWG exceeded 3 kilograms, the risk of adverse outcomes rose sharply, highlighting fluid overload as a powerful, modifiable trigger for heart strain and damage.

Survival analysis further revealed that patients with lower IDWG and without LVH had better long-term survival, whereas those combining high fluid gain and heart muscle thickening faced poorer outcomes and higher mortality. Overall, careful monitoring of fluid intake, stricter control of blood pressure, and early detection of LVH could significantly reduce heart-related complications in dialysis patients. The findings reinforce the need for patient education on fluid restriction and regular cardiovascular screening.

Source:

Rajendran, K., P V Mukundan, P., John, H. T., Chakravarthy, S. M., & Sreedhara, R. (2025). Interdialytic weight gain and cardiovascular risk in haemodialysis patients with chronic kidney disease: Findings from a prospective cohort study. Cureus, 17(11), e97495. https://doi.org/10.7759/cureus.97495