Cardiovascular risk factors in hemodialysis patients: results from baseline data of kaleidoscopic approaches to patients with end-stage renal disease study.
BACKGROUND
The prevalence of cardiovascular risk factors and the prevalence of comorbidities in adult hemodialysis patients in Japan are not fully understood.


METHODS
In "Kaleidoscopic Approaches to Patients with End-stage Renal Disease Study" (The KAREN Study, 2003), trained research stuff examined 1,214 adult hemodialysis patients (mean age, 61.2 years; 779 males and 435 females) of 1,506 patients in northern areas of Iwate Prefecture. Cardiovascular risk factors and the prevalence of comorbidities in hemodialysis patients were compared with those in the general population using direct age-adjustment methodology and standardized morbidity ratios (SMRs).


RESULTS
In hemodialysis patients, common causes of end-stage renal disease were chronic glomerulonephritis (29.8%), diabetic nephropathy (24.5%), and other diseases. Prevalence and SMR of myocardial infarction were 5% and 9.6, respectively, and those of stroke were 13% and 5.7. The prevalences of hypertension and diabetes mellitus were 87% and 29%, respectively. Mean systolic blood pressure and mean diastolic blood pressure were 155 mmHg and 85 mmHg, respectively. Mean levels of total serum cholesterol, high-density lipoprotein cholesterol, and albumin in patients with end-stage renal disease were lower than those of the general population (160.6 vs. 203.3 mg/dL, 48.5 vs. 59.7 mg/dL, and 3.7 vs. 4.4 g/dL, respectively). Mean levels of C-reactive protein were higher than those of the general population (3.80 vs. 1.16 mg/L).


CONCLUSIONS
Hemodialysis patients have a high prevalence of cardiovascular risk factors and comorbidities. Levels of nutrition-related markers were lower, and C-reactive protein levels were higher, in hemodialysis patients than in the general population.
Ohsawa
Masaki
M
Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Japan. masakio@iwate-med.ac.jp
Kato
Karen
K
Itai
Kazuyoshi
K
Onoda
Toshiyuki
T
Konda
Ryuichiro
R
Fujioka
Tomoaki
T
Nakamura
Motoyuki
M
Okayama
Akira
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires
D002097:C-Reactive Protein