title: Cardiovascular and noncardiovascular mortality among men and women starting dialysis.
abstract: OBJECTIVE
  Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women.
  
  
  METHODS
  We compared 5-year age-stratified cardiovascular and noncardiovascular mortality rates, relative risks, and hazard ratios in a European cohort of incident adult dialysis patients (European Renal Association-European Dialysis and Transplant Association [ERA-EDTA] Registry) with the European general population (Eurostat). Cause of death was recorded by ERA-EDTA codes in dialysis patients and by International Statistical Classification of Diseases codes in the general population.
  
  
  RESULTS
  Overall, sex did not have a predictive effect on outcome in dialysis. Stratification into age categories and causes of death showed greater noncardiovascular mortality in young women (<45 years). In other age categories (45 to 55 and >55 years), women presented lower cardiovascular mortality. This cardiovascular benefit was, however, smaller than in the general population. Stratification by diabetic nephropathy showed that diabetic women in all age categories remained at increased mortality risk compared with men, an effect mainly attributed to the noncardiovascular component.
  
  
  CONCLUSIONS
  Mortality rates and causes of death in men and women on dialysis vary with age. Increased noncardiovascular mortality may explain the loss of the survival advantage of women on dialysis. Both young and diabetic women starting dialysis are at a higher mortality risk than equal men.
authors: Division of Renal Medicine, Centre for Molecular Medicine and Centre for Gender Medicine, Karolinska Institutet, Stockholm, Sweden. Juan.Jesus.Carrero@ki.se
authors: Juan J
authors: JJ
authors: Carrero
authors: Dinanda J
authors: DJ
authors: de Jager
authors: Marion
authors: M
authors: Verduijn
authors: Pietro
authors: P
authors: Ravani
authors: Johan
authors: J
authors: De Meester
authors: James G
authors: JG
authors: Heaf
authors: Patrik
authors: P
authors: Finne
authors: Andries J
authors: AJ
authors: Hoitsma
authors: Julio
authors: J
authors: Pascual
authors: Faiçal
authors: F
authors: Jarraya
authors: Anna V
authors: AV
authors: Reisaeter
authors: Frederic
authors: F
authors: Collart
authors: Friedo W
authors: FW
authors: Dekker
authors: Kitty J
authors: KJ
authors: Jager
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult