COMPARATIVE MORTALITY FROM CARDIOVASCULAR-DISEASE IN PATIENTS WITH CHRONIC-RENAL-FAILURE

Citation
Jh. Brown et al., COMPARATIVE MORTALITY FROM CARDIOVASCULAR-DISEASE IN PATIENTS WITH CHRONIC-RENAL-FAILURE, Nephrology, dialysis, transplantation, 9(8), 1994, pp. 1136-1142
Citations number
38
Categorie Soggetti
Urology & Nephrology
ISSN journal
09310509
Volume
9
Issue
8
Year of publication
1994
Pages
1136 - 1142
Database
ISI
SICI code
0931-0509(1994)9:8<1136:CMFCIP>2.0.ZU;2-6
Abstract
Patients with chronic renal failure show an excess mortality from card iovascular disease (CVD). Over a 4-year period (1983-1986) we have pro spectively studied 305 patients (177 men, 128 women) from a geographic ally constrained population entering a renal replacement therapy (RRT) programme. The development of new cardiovascular events and patient s urvival have been documented up to the end of 1990. We have determined the incidence of CVD amongst the patients compared to the general pop ulation of the region and assessed the predictive value for future car diovascular events of risk factors present at the start of RRT. One hu ndred and fourteen patients experienced a new cardiovascular event. On e hundred and fifteen patients died, 89 from CVD. Stratification by ag e and sex identified diabetes, previous coronary heart disease, and ca rdiomegaly to be significantly associated with an increased risk of a cardiovascular event, and diabetes, previous coronary heart disease, a nd accelerated hypertension to be significantly associated with an inc reased risk of cardiovascular death. Mortality from CVD was 10.1 times that of the corresponding general population, and was increased 44 ti mes for patients with diabetes. Duration of RRT did not influence mort ality rates. This excessive early mortality has significant implicatio ns for RRT programmes and further research is necessary to identify in dividuals at risk and the modifiable risk factors that could receive t argeted interventional therapy.