Risk factors for cardiovascular hospitalization in hemodialysis patients.
The aim of this study was to evaluate the risk factors for cardiovascular hospitalization in hemodialysis patients.


METHODS
A cross-sectional cohort analysis of risk factors during one census month (November) and one-year follow-up for cardiovascular hospitalization rates during 5 consecutive years (2002-2006) in all end-stage renal disease patients hemodialyzed in Kaunas region was carried out. During the census month, we collected data on patient's age and sex, disability status, comorbidities, anemia control, malnutrition and inflammation, calcium-phosphorus metabolism, and patient's compliance with prescribed medications. We analyzed 559 patients during 1163 patient-years of observation. Patients were considered as new patients every year (1520 cases). Kaplan-Meier method and Cox regression analysis were used to evaluate time to first hospitalization.


RESULTS
The mean number of cardiovascular hospitalizations was 0.31 per patient-year at risk, the total days of cardiovascular hospitalizations per patient-year at risk were 3.93, and the mean length of one hospitalization was 13.2±12.9 days. Cardiovascular diseases were the most frequent cause of hospitalization (25% of all hospitalizations). The relative risk of cardiovascular hospitalization increased by 1.03 for every year of age, by 1.7 for worse disability status, by 1.4 for nonadherence to medications, by 1.1 for every additional medication prescribed to the patient. Cardiovascular hospitalization risk was decreased by 0.99 with a 1-g/L rise in hemoglobin level.


CONCLUSIONS
Older age, worse disability status, patient's noncompliance with medications, and higher number of medications used were associated with a higher risk for cardiovascular hospitalization. Higher hemoglobin level was associated with a lower risk for cardiovascular hospitalization.
Department of Nephrology, Kaunas University of Medicine, Eivenių 2, 50028 Kaunas, Lithuania. rutavaic@centras.lt
Rūta
R
Vaičiūnienė
Vytautas
V
Kuzminskis
Edita
E
Ziginskienė
Kristina
K
Petrulienė
D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D006233:Persons with Disabilities; D006400:Hematocrit; D006452:Hemoglobinometry; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D006435:Renal Dialysis; D012306:Risk; D012307:Risk Factors; D013997:Time Factors