title: Survival trends of US dialysis patients with heart failure: 1995 to 2005.
abstract: OBJECTIVE
  Congestive heart failure (CHF) is a major risk factor for death in end-stage kidney disease; however, data on prevalence and survival trends are limited. The objective of this study was to determine the prevalence and mortality effect of CHF in successive incident dialysis cohorts.
  
  
  METHODS
  This was a population-based cohort of incident US dialysis patients (n = 926,298) from 1995 to 2005. Age- and gender-specific prevalence of CHF was determined by incident year, whereas temporal trends in mortality were compared using multivariable Cox regression.
  
  
  RESULTS
  The prevalence of CHF was significantly higher in women than men and in older than younger patients, but it did not change over time in men (range 28% to 33%) or women (range 33% to 36%). From 1995 to 2005, incident death rates decreased for younger men (≤70 years) and increased for older men (>70 years). For women, the pattern was similar but less impressive. During this period, the adjusted mortality risks (relative risk [RR]) from CHF decreased in men (from RR = 1.06 95% Confidence intervals (CI) 1.02-1.11 in 1995 to 0.91 95% CI 0.87-0.96 in 2005) and women (from RR = 1.06 95% CI 1.01-1.10 in 1995 to 0.90 95% CI 0.85-0.95 in 2005 compared with referent year 2000; RR = 1.00). The reduction in mortality over time was greater for younger than older patients (20% to 30% versus 5% to 10% decrease per decade).
  
  
  CONCLUSIONS
  Although CHF remains a common condition at dialysis initiation, mortality risks in US patients have declined from 1995 to 2005.
authors.affiliation: Regional Kidney Centre, Department of Medicine, Letterkenny General Hospital, Letterkenny, Donegal, Ireland. Austin.Stack@hse.ie
authors.forename: Austin G
authors.initials: AG
authors.lastname: Stack
authors.forename: Amir
authors.initials: A
authors.lastname: Mohammed
authors.forename: Alan
authors.initials: A
authors.lastname: Hanley
authors.forename: Arif
authors.initials: A
authors.lastname: Mutwali
authors.forename: Hoang
authors.initials: H
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult