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The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.
Anderson, Jocelyn Glynn, Liam G Newell, John Iglesias, Alberto A Reddan, Donal Murphy, Andrew W
Anderson, Jocelyn
Glynn, Liam G
Newell, John
Iglesias, Alberto A
Reddan, Donal
Murphy, Andrew W
Advisors
Editors
Other Contributors
Date
2009
Date Submitted
Keywords
Other Subjects
Subject Mesh
Aged
Anemia
Cardiovascular Diseases
Cause of Death
Chi-Square Distribution
Cohort Studies
Comorbidity
Female
Humans
Ireland
Kaplan-Meiers Estimate
Male
Middle Aged
Prevalence
Proportional Hazards Models
Renal Insufficiency, Chronic
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Anemia
Cardiovascular Diseases
Cause of Death
Chi-Square Distribution
Cohort Studies
Comorbidity
Female
Humans
Ireland
Kaplan-Meiers Estimate
Male
Middle Aged
Prevalence
Proportional Hazards Models
Renal Insufficiency, Chronic
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Planned Date
Start Date
Collaborators
Principal Investigators
Files
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19909540.pdf
Adobe PDF, 276.37 KB
Alternative Titles
Publisher
Abstract
BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.
Language
en
ISSN
1471-2261
eISSN
ISBN
DOI
10.1186/1471-2261-9-51
PMID
19909540