title: Determinants of cardiovascular risk in haemodialysis patients: post hoc analyses of the AURORA study.
abstract: BACKGROUND
  Haemodialysis patients are at high risk for cardiovascular (CV) events. The aim of the current study was to characterise the role of traditional and uraemia-specific CV risk factors in this patient population.
  
  
  METHODS
  A post hoc analysis of the AURORA trial which enrolled 2,776 haemodialysis patients from 280 centres and had a mean follow-up period of 3.2 years. Determinants of CV endpoints (time to major cardiovascular event (MACE), cardiac event, CV death) were identified by univariate Cox regression analysis. Subsequently, independent determinants were identified by multivariate regression analysis.
  
  
  RESULTS
  For the primary endpoint MACE (myocardial infarction, stroke and cardiac death), multivariate analysis revealed that independent determinants were: age (hazard ratio (HR) 1.03 per year), serum phosphate level (HR 1.50 per mmol/l), albumin level (HR 0.94 per g/l), years on haemodialysis (HR 1.03 per year), diabetes mellitus (HR 1.38), preexisting coronary heart disease (HR 1.54) and C-reactive protein (CRP) level (HR 1.14 per mg/l). However, conventional risk factors such as smoking, dyslipidaemia, systolic and diastolic blood pressure and pulse pressure had no significant effect.
  
  
  CONCLUSIONS
  Although we identify CRP, low albumin, and high phosphorus as risk factors for MACE, lowering CRP did not influence MACE outcomes in our trial. Caution is therefore warranted in implying risk factors being causal in end-stage renal disease.
authors: Renal Research Group, British Heart Foundation Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. schneider_a6@medizin.uni-wuerzburg.de
authors: Andreas
authors: A
authors: Schneider
authors: Alan G
authors: AG
authors: Jardine
authors: Markus P
authors: MP
authors: Schneider
authors: Hallvard
authors: H
authors: Holdaas
authors: Ingar
authors: I
authors: Holme
authors: Bengt C
authors: BC
authors: Fellstroem
authors: Faiez
authors: F
authors: Zannad
authors: Roland E
authors: RE
authors: Schmieder
mesh_terms: D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality*; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D010710:Phosphates / Q000097:blood; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D012709:Serum Albumin; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors
chemical_list: D010710:Phosphates; D012709:Serum Albumin; D002097:C-Reactive Protein