TY - JOUR
T1 - Survival trends of us dialysis patients with heart failure
T2 - 1995 to 2005
AU - Stack, Austin G.
AU - Mohammed, Amir
AU - Hanley, Alan
AU - Mutwali, Arif
AU - Nguyen, Hoang
PY - 2011/8/1
Y1 - 2011/8/1
N2 - Background 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.
AB - Background 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.
UR - http://www.scopus.com/inward/record.url?scp=80051556904&partnerID=8YFLogxK
U2 - 10.2215/CJN.01130211
DO - 10.2215/CJN.01130211
M3 - Article
C2 - 21784821
AN - SCOPUS:80051556904
SN - 1555-9041
VL - 6
SP - 1982
EP - 1989
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 8
ER -