Schneider, A., Jardine, A.G. , Schneider, M.P., Holdaas, H., Holme, I., Fellstroem, B.C., Zannad, F. and Schmieder, R.E. (2013) Determinants of cardiovascular risk in haemodialysis patients: post hoc analyses of the AURORA study. American Journal of Nephrology, 37(2), pp. 144-151. (doi: 10.1159/000346710)
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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.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Schneider, Dr Markus and Schneider, Dr Andreas and Jardine, Professor Alan |
| Authors: | Schneider, A., Jardine, A.G., Schneider, M.P., Holdaas, H., Holme, I., Fellstroem, B.C., Zannad, F., and Schmieder, R.E. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | American Journal of Nephrology |
| Publisher: | S. Karger AG |
| ISSN: | 0250-8095 |
| ISSN (Online): | 1421-9670 |
| Published Online: | 31 January 2013 |
| Related URLs: |
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