title: Mortality due to pulmonary embolism, myocardial infarction, and stroke among incident dialysis patients.
abstract: BACKGROUND
  It is has been suggested that dialysis patients have lower mortality rates for pulmonary embolism than the general population, because of platelet dysfunction and bleeding tendency. However, there is limited information whether dialysis is indeed associated with a decreased mortality risk from pulmonary embolism.
  
  
  OBJECTIVE
  The aim of our study was to evaluate whether mortality rate ratios for pulmonary embolism were lower than for myocardial infarction and stroke in dialysis patients compared with the general population.
  
  
  METHODS
  Cardiovascular causes of death for 130,439 incident dialysis patients registered in the ERA-EDTA Registry were compared with the cardiovascular causes of death for the European general population.
  
  
  RESULTS
  The age- and sex-standardized mortality rate (SMR) from pulmonary embolism was 12.2 (95% CI 10.2-14.6) times higher in dialysis patients than in the general population. The SMRs in dialysis patients compared with the general population were 11.0 (95% CI 10.6-11.4) for myocardial infarction, 8.4 (95% CI 8.0-8.8) for stroke, and 8.3 (95% CI 8.0-8.5) for other cardiovascular diseases. In dialysis patients, primary kidney disease due to diabetes was associated with an increased mortality risk due to pulmonary embolism (HR 1.9; 95% CI 1.0-3.8), myocardial infarction (HR 4.1; 95% CI 3.4-4.9), stroke (HR 3.5; 95% CI 2.8-4.4), and other cardiovascular causes of death (HR 3.4; 95% CI 2.9-3.9) compared with patients with polycystic kidney disease.
  
  
  CONCLUSIONS
  Dialysis patients were found to have an unexpected highly increased mortality rate for pulmonary embolism and increased mortality rates for myocardial infarction and stroke.
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. g.ocak@lumc.nl
authors.forename: G
authors.initials: G
authors.lastname: Ocak
authors.forename: K J
authors.initials: KJ
authors.lastname: van Stralen
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
authors.forename: M
authors.initials: M
authors.lastname: Verduijn
authors.forename: P
authors.initials: P
authors.lastname: Ravani
authors.forename: R
authors.initials: R
authors.lastname: Palsson
authors.forename: T
authors.initials: T
authors.lastname: Leivestad
authors.forename: A J
authors.initials: AJ
authors.lastname: Hoitsma
authors.forename: M
authors.initials: M
authors.lastname: Ferrer-Alamar
authors.forename: P
authors.initials: P
authors.lastname: Finne
authors.forename: J
authors.initials: J
authors.lastname: De Meester
authors.forename: C
authors.initials: C
authors.lastname: Wanner
authors.forename: F W
authors.initials: FW
authors.lastname: Dekker
authors.forename: K J
authors.initials: KJ
authors.lastname: Jager
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality*; D011655:Pulmonary Embolism / Q000401:mortality*; D006435:Renal Dialysis; D020521:Stroke / Q000401:mortality*