Paper Title
Clinical Markers Predicting Cardiovascular Diseases in End-Stage Renal Disease Patients on Haemodialysis

Abstract
Introduction - Statistics by the Malaysian Dialysis and Transplant Registry and United States Renal Data System reveal that cardiovascular disease (CVD) is the number one cause of death for end-stage renal disease (ESRD) patients on haemodialysis. Sudden cardiac death tops the list of cardiovascular mortality, with malignant arrythmia as the main culprit. Despite multiple literatures highlighting this, a pilot study carried out within haemodialysis centres in Malaysia with 166 respondents in year 2020, revealed routine CVD screening is not a standard practice. Objectives: This research aims to identify adequacy of six routine biomarkers, such as serum haemoglobin, albumin, alkaline phosphatase, calcium, phosphate, and intact parathyroid hormone in detecting underlying CVD in this population. The null hypothesis suggests no correlation, whereas the alternative hypothesis suggests otherwise, necessitating more specific CVD stratification method. Methodology: This is a case control study which took place within nine haemodialysis centres in different states in Malaysia, amongst patients who had cardiac deaths and hospitalizations, and those who did not, for the year 2020. The mean of the selected biomarkers for one year prior to development of cardiac events in the case group – are studied. Amongst those in control groups, twenty-three also had electrocardiographic (ECG) study done, which are assessed as well. Results & Conclusion: Null hypothesis is rejected; mean albumin level displayed a significant p<0.05 in the 1-way ANOVA test and multiple regression analysis, paving way for further study, while the other biomarkers are statistically not significant. The alternative hypothesis suggests adding ECG as routine clinical screening for this population for early mitigation and potentially increase the quality of life amongst this population Table I – Results of the Investigation Keywords - “Cardiovascular Disease”, “End-stage renal disease”, “hemodialysis”, “Malaysia”, “clinical markers”