Mortality and Associated Risk Factors in Dialysis Patients with Cardiovascular Disease

Abstract

Background/Aims: Although dialysis patients have a higher risk of morbidity and mortality related to cardiovascular disease (CVD) than the general population, the mortality and associated risk factors in Asian dialysis patients with CVD have not been well examined. Methods: In this prospective cohort study, mortality and risk factors were investigated in 591 dialysis patients who were recruited from two dialysis centers from May 1, 2009 to May 1, 2014. The Cox proportional hazards regression assessed adjusted differences in mortality risk. A multivariate analysis was also performed, comparing the CVD and non-CVD groups. Results: A total of 591 patients were enrolled in this study (mean age, 52.05 ± 16.46 years [SD]; 61.8% men; 20.8% with CVD), with a median follow-up of 21.9 (maximum, 72) months. The cumulative hazard of mortality was significantly higher in CVD patients (hazard ratio [HR], 1.835; 95% confidence interval [CI], 1.023-3.293; P=0.042) than in their non-CVD counterparts after adjusting for various confounders. On multivariate Cox analysis, stroke (HR, 4.574; 95% CI, 2.149-9.736; P<0.001) was an independent predictor of all-cause mortality in the CVD group. In the non-CVD group, diabetes mellitus (HR, 2.974; 95% CI, 1.560-5.668; P=0.001) and elevated high-sensitivity C-reactive lipoprotein (hs-CRP) (HR, 1.017; 95% CI, 1.005-1.030; P=0.005) were independent predictors of all-cause mortality. Conclusion: All-cause mortality was significantly higher in the CVD group than in the non-CVD group. Stroke is an independent risk factor for all-cause mortality in dialysis patients with CVD. These findings warrant further studies into preventive and interventional strategies.

Association of Pulse Volume Recording at Ankle with Total and Cardiovascular Mortality in Hemodialysis Patients

“…Several traditional cardiovascular risk factors, such as diabetes, coronary artery disease, stroke, and chronic heart failure were useful predictors of mortality in HD patients [19][20][21]. In the present study, the hazard ratios (HRs) of these traditional cardiovascular risk factors for the prediction of total mortality were between 2.153 and 4.392 in the univariate analysis.…”

The predictive study of the relation between elevated low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and mortality in peritoneal dialysis

“…Cardiovascular disease (CVD) is considered to be the most common cause of mortality among patients with chronic kidney disease (CKD) [1][2][3]. Accounting for nearly 50% of deaths among patients on dialysis, cardiovascular mortality in this group is 10 to 30 times higher than that in the general population [4,5].…”

Chelerythrine Attenuates Renal Ischemia/ Reperfusion-induced Myocardial Injury by Activating CSE/H2S via PKC/NF-κB Pathway in Diabetic Rats

“…The increased expressions of PKC-α and PKC-β 2 mRNA are the primary cause of myocardial injury in DM [41, 42], however, the underlying downstream signal transduction pathway of PKC is still not completely understood. In addition, hyperglycemia can induce the formation of oxygen free radicals, promote the deposition of extracellular matrix, and decrease the diastolic function of the heart [43-46].…”