Cardiovascular and non-cardiovascular mortality in dialysis patients: where is the link?

doi:10.1038/kisup.2011.7

Review

. 2011 Jun;1(1):21-23.

doi: 10.1038/kisup.2011.7.

Cardiovascular and non-cardiovascular mortality in dialysis patients: where is the link?

Kitty J Jager¹, Bengt Lindholm², David Goldsmith³, Danilo Fliser⁴, Andrzej Wiecek⁵, Gultekin Suleymanlar⁶, Alberto Ortiz⁷, Ziad Massy⁸, Alberto Martinez-Castelao⁹, Rajiv Agarwal¹⁰, Peter J Blankestijn¹¹, Adrian Covic¹², Gerard London¹³, Carmine Zoccali¹⁴, Friedo W Dekker¹⁵; for EUropean REnal and CArdiovascular Medicine working group of the European Renal Association–European Dialysis and Transplant Association (ERA–EDTA)

Affiliations

¹ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands.
² Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm, Sweden.
³ Renal Unit, Guy's and St Thomas' NHS Foundation Hospital, King's Health Partners , London, UK.
⁴ Department of Internal Medicine IV, Saarland University Medical Centre , Homburg/Saar, Germany.
⁵ Division of Internal Medicine and Nephrology, Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia , Katowice, Poland.
⁶ Nephrology Division, Department of Medicine, Akdeniz University Medical School , Antalya, Turkey.
⁷ IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo , Madrid, Spain.
⁸ INSERM ERI-12 (EA 4292) , Amiens, France ; Amiens University Hospital and the Jules Verne University of Picardie , Amiens, France.
⁹ Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona, Spain.
¹⁰ Indiana University and VAMC , Indianapolis, Indiana, USA.
¹¹ Department of Nephrology, University Medical Center , Utrecht, The Netherlands.
¹² C.I. Parhon University Hospital and Gr. T. Popa University of Medicine and Pharmacy , Iasi, Romania.
¹³ INSERM U970, Hôpital Européen Georges Pompidou , Paris, France.
¹⁴ Nephrology, Dialysis and Transplantation Unit and CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension , Reggio Calabria, Italy.
¹⁵ Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, The Netherlands.

PMID: 25028623
PMCID: PMC4089722
DOI: 10.1038/kisup.2011.7

Review

Cardiovascular and non-cardiovascular mortality in dialysis patients: where is the link?

Kitty J Jager et al. Kidney Int Suppl (2011). 2011 Jun.

. 2011 Jun;1(1):21-23.

doi: 10.1038/kisup.2011.7.

Authors

Affiliations

¹ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands.
² Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm, Sweden.
³ Renal Unit, Guy's and St Thomas' NHS Foundation Hospital, King's Health Partners , London, UK.
⁴ Department of Internal Medicine IV, Saarland University Medical Centre , Homburg/Saar, Germany.
⁵ Division of Internal Medicine and Nephrology, Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia , Katowice, Poland.
⁶ Nephrology Division, Department of Medicine, Akdeniz University Medical School , Antalya, Turkey.
⁷ IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo , Madrid, Spain.
⁸ INSERM ERI-12 (EA 4292) , Amiens, France ; Amiens University Hospital and the Jules Verne University of Picardie , Amiens, France.
⁹ Hospital Universitario de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona, Spain.
¹⁰ Indiana University and VAMC , Indianapolis, Indiana, USA.
¹¹ Department of Nephrology, University Medical Center , Utrecht, The Netherlands.
¹² C.I. Parhon University Hospital and Gr. T. Popa University of Medicine and Pharmacy , Iasi, Romania.
¹³ INSERM U970, Hôpital Européen Georges Pompidou , Paris, France.
¹⁴ Nephrology, Dialysis and Transplantation Unit and CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension , Reggio Calabria, Italy.
¹⁵ Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, The Netherlands.

PMID: 25028623
PMCID: PMC4089722
DOI: 10.1038/kisup.2011.7

Abstract

Over the past decade, the research agenda in dialysis has been dominated by studies on risk factors associated with cardiovascular mortality. It has now become increasingly clear that in dialysis patients, non-cardiovascular causes of death are increased to the same extent as cardiovascular mortality, and therefore research efforts in this area deserve an equally prominent place on the nephrology research agenda. As previous research has suggested an association between cardiovascular disease and infections, more research on potential links between the causal pathways of cardiovascular events and infections is also warranted.

Keywords: cardiovascular disease; cardiovascular mortality; dialysis; mortality; non-cardiovascular mortality; renal replacement therapy.

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Figures

**Figure 1**
Proposal for a new research agenda on the cardiovascular–renal and non-cardiovascular–renal links.

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References

1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32 (Suppl 3:S112–S119. - PubMed
1. de Jager DJ, Grootendorst DC, Jager KJ, et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA. 2009;302:1782–1789. - PubMed
1. Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int. 2000;58:1758–1764. - PubMed
1. Sarnak MJ, Jaber BL. Pulmonary infectious mortality among patients with end-stage renal disease. Chest. 2001;120:1883–1887. - PubMed
1. Fried LF, Katz R, Sarnak MJ, et al. Kidney function as a predictor of noncardiovascular mortality. J Am Soc Nephrol. 2005;16:3728–3735. - PubMed

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[1] Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32 (Suppl 3:S112–S119. - PubMed

[2] Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32 (Suppl 3:S112–S119. - PubMed

[3] de Jager DJ, Grootendorst DC, Jager KJ, et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA. 2009;302:1782–1789. - PubMed

[4] de Jager DJ, Grootendorst DC, Jager KJ, et al. Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA. 2009;302:1782–1789. - PubMed

[5] Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int. 2000;58:1758–1764. - PubMed

[6] Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int. 2000;58:1758–1764. - PubMed

[7] Sarnak MJ, Jaber BL. Pulmonary infectious mortality among patients with end-stage renal disease. Chest. 2001;120:1883–1887. - PubMed

[8] Sarnak MJ, Jaber BL. Pulmonary infectious mortality among patients with end-stage renal disease. Chest. 2001;120:1883–1887. - PubMed

[9] Fried LF, Katz R, Sarnak MJ, et al. Kidney function as a predictor of noncardiovascular mortality. J Am Soc Nephrol. 2005;16:3728–3735. - PubMed

[10] Fried LF, Katz R, Sarnak MJ, et al. Kidney function as a predictor of noncardiovascular mortality. J Am Soc Nephrol. 2005;16:3728–3735. - PubMed

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Cardiovascular and non-cardiovascular mortality in dialysis patients: where is the link?

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Cardiovascular and non-cardiovascular mortality in dialysis patients: where is the link?

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