Heart failure as a cause for hospitalization in chronic dialysis patients
| Autor: | Allen J. Taylor, Fernando C Trespalacios, Kevin C. Abbott, George L. Bakris, Lawrence Y. Agodoa |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Adrenergic beta-Antagonists Angiotensin-Converting Enzyme Inhibitors Comorbidity Peritoneal dialysis Cohort Studies Recurrence Renal Dialysis Risk Factors Internal medicine medicine Humans Mortality Risk factor Dialysis Aged Retrospective Studies Heart Failure Aspirin business.industry Incidence Mortality rate Hazard ratio Cardiovascular Agents Retrospective cohort study Middle Aged Survival Analysis Drug Utilization Surgery Hospitalization Nephrology Kidney Failure Chronic Female Hemodialysis business Peritoneal Dialysis Cohort study |
| Zdroj: | American Journal of Kidney Diseases. 41:1267-1277 |
| ISSN: | 0272-6386 |
| DOI: | 10.1016/s0272-6386(03)00359-7 |
| Popis: | Background: Risk factors for heart failure (HF) have not been reported previously in a nationally representative sample of dialysis patients. Methods: We conducted a historic cohort study of 1,995 patients enrolled in the US Renal Data System Dialysis Morbidity and Mortality Study Wave 2 who were Medicare eligible at the study start and were followed up until December 31, 1999, or receipt of a renal transplant. Cox regression analysis was used to model associations with time to first hospitalization for both recurrent and de novo HF (International Classification of Diseases, Ninth Revision code 428.x), defined as patients with and without a history of HF, respectively. Results: The incidence density of HF was 71/1,000 person-years. Angiotensin-converting enzyme inhibitors and β-blockers were each used in less than 25% of patients with a known history of HF. A history of coronary heart disease was associated with an increased total risk for HF, as were hemodialysis (versus peritoneal dialysis), aspirin use, and a history of diabetes. However, hemodialysis and aspirin use were the only factors associated with both de novo and recurrent HF. Widened pulse pressure was associated with de novo HF. The mortality rate after HF was 83% at 3 years (adjusted hazard ratio for mortality, 2.10; 95% confidence interval, 1.80 to 2.45; P Conclusion: In chronic dialysis patients, hemodialysis and aspirin use were associated with increased risk for both total and de novo HF. Hospitalized HF was associated with a significantly increased risk for death. |
| Databáze: | OpenAIRE |
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