Associations of marital status with mortality from all causes and mortality from cardiovascular disease in Japanese haemodialysis patients.
BACKGROUND
Marital status is an important social factor associated with increased mortality from cardiovascular disease (CVD) and all causes. However, there has been no study on the association of marital status with mortality in haemodialysis patients.


METHODS
We analysed data from a 5-year prospective cohort study of 1064 Japanese haemodialysis patients aged 30 years or older. Marital status was classified into three groups: married, single and divorced/widowed. Cox's regression was used to estimate multivariate hazard ratios (HRs) [95% confidence intervals (CIs)] for all-cause mortality and CVD mortality according to marital status after adjusting for age, sex, duration of haemodialysis, cause of renal failure, body mass index, systolic blood pressure, total cholesterol, high density lipoprotein-cholesterol, albumin, high-sensitivity C-reactive protein, co-morbid conditions, smoking, alcohol consumption, education levels and job status.


RESULTS
Single patients had higher risks than married patients for mortality from all causes (HR = 1.51, 95% CI: 1.06-2.16) and mortality from CVD (HR = 1.68, 95% CI: 1.03-2.76), and divorced/widowed patients had a higher risk than married patients for mortality from CVD (HR = 1.73, 95% CI: 1.15-2.60). After stratification by age, single patients aged 30-59 years had significantly higher risks for all-cause mortality and CVD mortality.


CONCLUSIONS
The findings suggest that single status is a significant predictor for all-cause mortality and CVD mortality and that divorced/widowed status is a significant predictor for CVD mortality in haemodialysis patients.
School of Medicine,Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694, Japan. ktanno@iwate-med.ac.jp
Kozo
K
Tanno
Masaki
M
Ohsawa
Kazuyoshi
K
Itai
Karen
K
Kato
Tanvir Chowdhury
TC
Turin
Toshiyuki
T
Onoda
Kiyomi
K
Sakata
Akira
A
Okayama
Tomoaki
T
Fujioka
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D004243:Divorce / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000401:mortality; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D017805:Widowhood / Q000706:statistics & numerical data; D055815:Young Adult