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International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular

Maki Yoshino1, Martin K Kuhlmann, Peter Kotanko

  • 1Renal Research Institute, 207 East 94th Street, Suite 303, New York, NY 10128, USA.

Journal of the American Society of Nephrology : JASN
|November 17, 2006
PubMed

Insights

Mortality from atherosclerotic cardiovascular disease (ASCVD) in dialysis patients correlates with general population rates. This suggests shared genetic and environmental factors influence ASCVD deaths in both groups.

Area of Science:

  • Nephrology
  • Epidemiology
  • Cardiovascular Medicine

Background:

  • Dialysis patient mortality rates show unexplained national, racial, and ethnic disparities.
  • Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death in the general population and dialysis patients.

Purpose of the Study:

  • To investigate the correlation between ASCVD mortality rates in dialysis populations (DP) and the general population (GP).
  • To determine if background ASCVD mortality rates in the GP explain variations in DP mortality.

Main Methods:

  • Cross-sectional, multinational study comparing all-cause and ASCVD mortality rates.
  • Utilized World Health Organization mortality data (67 countries) and national renal registry data (26 countries).
  • Statistical analysis included correlation and regression, with adjustment for age.

Main Results:

  • Both all-cause and ASCVD mortality rates were significantly higher in DP compared to GP.
  • Strong positive correlation found between ASCVD mortality rates in DP and GP (R² = 0.56, P < 0.0001) after age adjustment.
  • Variability in DP mortality rates was substantially explained by background ASCVD mortality rates in the GP.

Conclusions:

  • ASCVD mortality rates in dialysis patients are strongly linked to those in the general population.
  • Genetic and environmental factors likely contribute to observed differences in ASCVD mortality across populations.
  • Understanding these correlations can inform strategies to reduce disparities in dialysis patient outcomes.

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