title: Risk factors and underlying cardiovascular diseases in incident ESRD patients.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in dialysis patients. The aim of this study was to evaluate the prevalence of cardiovascular risk factors and of CVD on admission to hemodialysis.
  
  
  METHODS
  Data were collected in 31 Italian clinics belonging to a clinic network using a prospective database (EuCliD), the main purpose of which is the support of quality assurance. Six hundred and thirty-six patients, mean age 63.9+/-15.4 years, admitted between January 1, 2000 and September 30, 2003, were separated into two groups on the basis of presence of CVD and observed for a median follow-up period of 16 months.
  
  
  RESULTS
  In the CVD group, patients were significantly older and the percentage of diabetics and smokers was significantly greater than in the CVD-free group. There were no significant differences between the groups in term of uremia-related risk factors. According to logistic regression analysis evaluating the impact of traditional and nontraditional cardiovascular risk factors, only smoking habit (OR 1.87, 95% CI 1.25-2.79) and diabetes (OR 1.87, 95% CI 1.19-2.95) were associated with a higher relative risk for the presence of CVD at baseline. At the time of admission, CVD was present in 27% of patients. The following de novo development of CVD was observed: hypertensive disease (0.28 new cases/100 pt-years), ischemic heart disease (0.71 new cases/100 pt-years), other forms of heart disease (1.57 new cases/100 pt-years), disease of arteries, arterioles, etc. (1.85 new cases/100 pt-years) and cerebrovascular disease (0.71 new cases/100 pt-years). The rate of developing de novo CVD events was 3.70 per 100 patient-years.
  
  
  CONCLUSIONS
  The prevalence of cardiovascular risk factors is already high at admission to dialysis. Despite the care provided to dialysis patients, a significant proportion of patients develop de novo CVD.
authors.affiliation: NephroCare Medical Direction, Fresenius Medical Care Italy, Naples--Italy. attilio.dibenedetto@fmc-ag.com
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Benedetto
authors.forename: Daniele
authors.initials: D
authors.lastname: Marcelli
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Gennaro
authors.initials: G
authors.lastname: Cice
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Isa
authors.forename: Fabio
authors.initials: F
authors.lastname: Cappabianca
authors.forename: Giulia
authors.initials: G
authors.lastname: Pacchiano
authors.forename: Roberta
authors.initials: R
authors.lastname: D'Amato
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Oggero
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonanno
authors.forename: Ornella
authors.initials: O
authors.lastname: Pergamo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D017582:Renal Replacement Therapy; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014511:Uremia / Q000453:epidemiology