title: High mortality rate in hemodialysis patients who undergo invasive cardiovascular procedures related to peripheral artery disease - community-based observational study in Kumamoto Prefecture - .
abstract: BACKGROUND
  Cardiovascular disease is a major cause of mortality in hemodialysis patients. The aim was to assess the relationship of various invasive cardiovascular procedures (ICP) to clinical outcome in hemodialysis patients.
  
  
  RESULTS
  A total of 5,813 patients at 76 facilities were on maintenance hemodialysis in Kumamoto Prefecture. Of these, 4,807 patients at 58 institutions were enrolled. Of 4,807 patients, 212 ICP (4.4%) were performed for various cardiovascular diseases in 189 patients (3.9%). ICP included PCI (n=80), endovascular treatment (n=59), radiofrequency catheter ablation (n=8), implantation of permanent pacemaker (n=15) and ICD (n=5), thoracotomy for valvular diseases (n=16), CABG (n=14), bypass surgery for peripheral artery disease (PAD; n=8), and artificial vessel replacement for aneurysm or aortic dissection (n=7). The overall mortality rate was 10.1% (19/189 patients). The mortality rate was highest in patients who underwent ICP for PAD, compared with other ICP (PAD, 18.2%; non-PAD, 6.7%, P=0.017). Infection and PAD were significant predictors of mortality (infection: OR, 8.30; 95% CI: 1.29-65.13, P=0.027; PAD: OR, 3.76; 95% CI: 1.35-10.48, P=0.012). The presence of inflammation/malnutrition factors was associated with high mortality (OR, 15.49; 95% CI: 3.22-74.12, P=0.0006).
  
  
  CONCLUSIONS
  In this community-based registry study of 4,807 hemodialysis patients, the mortality rate of PAD patients was high despite ICP.
authors: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University.
authors: Seiji
authors: S
authors: Hokimoto
authors: Kenji
authors: K
authors: Sakamoto
authors: Tomonori
authors: T
authors: Akasaka
authors: Koichi
authors: K
authors: Kaikita
authors: Osamu
authors: O
authors: Honda
authors: Masahiro
authors: M
authors: Naruse
authors: Hisao
authors: H
authors: Ogawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000009:adverse effects / Q000706:statistics & numerical data; D002423:Cause of Death; D015897:Comorbidity; D017147:Defibrillators, Implantable; D003935:Diagnostic Techniques, Cardiovascular / Q000009:adverse effects / Q000706:statistics & numerical data*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007239:Infections / Q000401:mortality; D007249:Inflammation / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000706:statistics & numerical data; D009369:Neoplasms / Q000401:mortality; D010138:Pacemaker, Artificial; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000706:statistics & numerical data; D012042:Registries; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D013908:Thoracotomy / Q000009:adverse effects / Q000706:statistics & numerical data; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data