title: Mortality and Associated Risk Factors in Dialysis Patients with Cardiovascular Disease.
abstract: OBJECTIVE
  Although dialysis patients have a higher risk of morbidity and mortality related to cardiovascular disease (CVD) than the general population, the mortality and associated risk factors in Asian dialysis patients with CVD have not been well examined.
  
  
  METHODS
  In this prospective cohort study, mortality and risk factors were investigated in 591 dialysis patients who were recruited from two dialysis centers from May 1, 2009 to May 1, 2014. The Cox proportional hazards regression assessed adjusted differences in mortality risk. A multivariate analysis was also performed, comparing the CVD and non-CVD groups.
  
  
  RESULTS
  A total of 591 patients were enrolled in this study (mean age, 52.05 ± 16.46 years [SD]; 61.8% men; 20.8% with CVD), with a median follow-up of 21.9 (maximum, 72) months. The cumulative hazard of mortality was significantly higher in CVD patients (hazard ratio [HR], 1.835; 95% confidence interval [CI], 1.023-3.293; P=0.042) than in their non-CVD counterparts after adjusting for various confounders. On multivariate Cox analysis, stroke (HR, 4.574; 95% CI, 2.149-9.736; P<0.001) was an independent predictor of all-cause mortality in the CVD group. In the non-CVD group, diabetes mellitus (HR, 2.974; 95% CI, 1.560-5.668; P=0.001) and elevated high-sensitivity C-reactive lipoprotein (hs-CRP) (HR, 1.017; 95% CI, 1.005-1.030; P=0.005) were independent predictors of all-cause mortality.
  
  
  CONCLUSIONS
  All-cause mortality was significantly higher in the CVD group than in the non-CVD group. Stroke is an independent risk factor for all-cause mortality in dialysis patients with CVD. These findings warrant further studies into preventive and interventional strategies.
authors.affiliation: Department of Nephrology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China.
authors.forename: Junrong
authors.initials: J
authors.lastname: Tong
authors.forename: Manyi
authors.initials: M
authors.lastname: Liu
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Zhengmao
authors.initials: Z
authors.lastname: Luo
authors.forename: Xianyang
authors.initials: X
authors.lastname: Zhong
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.forename: Riguang
authors.initials: R
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: He
authors.forename: Junzhou
authors.initials: J
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality*; D012307:Risk Factors; D020521:Stroke / Q000401:mortality; D016019:Survival Analysis