Cardiovascular Mortality Rate Declining in Dialysis Patients
Compared with the general population, however, their risk of dying from cardiovascular causes is increasing.
DENVER—Although the cardiovascular mortality rate (CVMR) among dialysis patients is declining, the risk of cardiovascular mortality is increasing over time compared with the general population, according to Australian researchers.
Matthew A. Roberts, MBBS, PhD, of Austin Health in Victoria, and colleagues calculated CVMR from ANZDATA Registry data for Australian patients receiving dialysis from 1992 to 2005, and from the Australian Bureau of Statistics data for the comparable general population.
From 1992-1994 to 2004-2005, age-stratified CVMR (per 100 person-years) decreased in dialysis patients aged 55-74 years, declining from 7.3 to 6.0 among those aged 55-64, from 9.4 to 6.6 among those aged 65-74, and from 14.2 to 10.2 among those aged 75-84, the investigators reported. Between those two periods, however, the relative risk of cardiovascular mortality increased among dialysis patients. In 1992-1994, the risk among dialysis patients aged 55-64 was 26.3 times greater than that of the general population. In 2004-2005, the risk was 49.2 times greater. In 1992-1994, the relative risk of cardiovascular mortality was 10.5 times and 4.8 times greater for dialysis patients aged 65-74 and 75-84, respectively. In 2004-2005, the risk was 16.6 and 6.4 times greater, respectively.
The relative risk for cardiovascular mortality increased markedly with younger age and also increased over time, Dr. Roberts' group noted. For example, in 1992-1994, dialysis patients aged 35-44 had a cardiovascular risk 122 times than of the general population. In 2004-2005, the risk was 192 times greater.
“The gap in cardiovascular mortality between patients on dialysis and those [who are] not is increasing,” Dr. Roberts told Renal & Urology News. “Whether this is due to factors related to the patients entering dialysis programs in the modern era, a lack of use of ‘proven' cardiovascular therapies, or a lack of effect of these cardiovascular therapies in patients on dialysis, remains to be worked out.”