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dc.contributor.authorStack, Austin G
dc.contributor.authorMohammed, Amir
dc.contributor.authorHanley, Alan
dc.contributor.authorMutwali, Arif
dc.contributor.authorNguyen, Hoang
dc.date.accessioned2012-01-31T16:31:12Z
dc.date.available2012-01-31T16:31:12Z
dc.date.issued2012-01-31T16:31:12Z
dc.identifier.citationClin J Am Soc Nephrol. 2011 Aug;6(8):1982-9. Epub 2011 Jul 22.en_GB
dc.identifier.issn1555-905X (Electronic)en_GB
dc.identifier.issn1555-9041 (Linking)en_GB
dc.identifier.pmid21784821en_GB
dc.identifier.doi10.2215/CJN.01130211en_GB
dc.identifier.urihttp://hdl.handle.net/10147/205738
dc.description.abstractBACKGROUND AND OBJECTIVES: Congestive heart failure (CHF) is a major risk factor for death in end-stage kidney disease; however, data on prevalence and survival trends are limited. The objective of this study was to determine the prevalence and mortality effect of CHF in successive incident dialysis cohorts. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a population-based cohort of incident US dialysis patients (n = 926,298) from 1995 to 2005. Age- and gender-specific prevalence of CHF was determined by incident year, whereas temporal trends in mortality were compared using multivariable Cox regression. RESULTS: The prevalence of CHF was significantly higher in women than men and in older than younger patients, but it did not change over time in men (range 28% to 33%) or women (range 33% to 36%). From 1995 to 2005, incident death rates decreased for younger men (70 years). For women, the pattern was similar but less impressive. During this period, the adjusted mortality risks (relative risk [RR]) from CHF decreased in men (from RR = 1.06 95% Confidence intervals (CI) 1.02-1.11 in 1995 to 0.91 95% CI 0.87-0.96 in 2005) and women (from RR = 1.06 95% CI 1.01-1.10 in 1995 to 0.90 95% CI 0.85-0.95 in 2005 compared with referent year 2000; RR = 1.00). The reduction in mortality over time was greater for younger than older patients (20% to 30% versus 5% to 10% decrease per decade). CONCLUSIONS: Although CHF remains a common condition at dialysis initiation, mortality risks in US patients have declined from 1995 to 2005.
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAnalysis of Varianceen_GB
dc.subject.meshChi-Square Distributionen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHeart Failure/*mortalityen_GB
dc.subject.meshHumansen_GB
dc.subject.meshKidney Failure, Chronic/*mortality/*therapyen_GB
dc.subject.meshLogistic Modelsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshOdds Ratioen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshProportional Hazards Modelsen_GB
dc.subject.meshRenal Dialysis/*mortalityen_GB
dc.subject.meshRisk Assessmenten_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshSex Factorsen_GB
dc.subject.meshSurvival Analysisen_GB
dc.subject.meshSurvival Rateen_GB
dc.subject.meshTime Factorsen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshUnited States/epidemiologyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleSurvival trends of US dialysis patients with heart failure: 1995 to 2005.en_GB
dc.contributor.departmentRegional Kidney Centre, Department of Medicine, Letterkenny General Hospital,, Letterkenny, Donegal, Ireland. Austin.Stack@hse.ieen_GB
dc.identifier.journalClinical journal of the American Society of Nephrology : CJASNen_GB
dc.description.provinceUlster
html.description.abstractBACKGROUND AND OBJECTIVES: Congestive heart failure (CHF) is a major risk factor for death in end-stage kidney disease; however, data on prevalence and survival trends are limited. The objective of this study was to determine the prevalence and mortality effect of CHF in successive incident dialysis cohorts. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a population-based cohort of incident US dialysis patients (n = 926,298) from 1995 to 2005. Age- and gender-specific prevalence of CHF was determined by incident year, whereas temporal trends in mortality were compared using multivariable Cox regression. RESULTS: The prevalence of CHF was significantly higher in women than men and in older than younger patients, but it did not change over time in men (range 28% to 33%) or women (range 33% to 36%). From 1995 to 2005, incident death rates decreased for younger men (</=70 years) and increased for older men (>70 years). For women, the pattern was similar but less impressive. During this period, the adjusted mortality risks (relative risk [RR]) from CHF decreased in men (from RR = 1.06 95% Confidence intervals (CI) 1.02-1.11 in 1995 to 0.91 95% CI 0.87-0.96 in 2005) and women (from RR = 1.06 95% CI 1.01-1.10 in 1995 to 0.90 95% CI 0.85-0.95 in 2005 compared with referent year 2000; RR = 1.00). The reduction in mortality over time was greater for younger than older patients (20% to 30% versus 5% to 10% decrease per decade). CONCLUSIONS: Although CHF remains a common condition at dialysis initiation, mortality risks in US patients have declined from 1995 to 2005.


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