Cardiovascular and Noncardiovascular Mortality among Men and Women Starting Dialysis
Cardiovascular and Noncardiovascular Mortality among Men and Women Starting Dialysis
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DOI：
10.2215/cjn.11331210
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发表时间：
2011-07-01
影响因子：
9.8
通讯作者：
Jager, Kitty J.
中科院分区：
文献类型：
--
作者：
Carrero, Juan J.;de Jager, Dinanda J.;Jager, Kitty J.
背景和目的虽然女性在一般人群中具有生存优势，但接受透析的女性的死亡率与男性相似。我们假设透析期间的这种成对死亡风险可能是由女性心血管相关死亡率相对过高来解释的。设计，设置，参与者和测量我们比较了5岁年龄分层的心血管和非心血管死亡率，相对风险，一个欧洲成人透析患者队列的风险比（欧洲肾脏协会-欧洲透析和移植协会[ERA-EDTA]登记处）与欧洲普通人群（欧统局）。死亡原因记录的ERA-EDTA代码在透析患者和国际疾病统计分类的代码在一般population.Results总体而言，性别没有透析结果的预测作用。按年龄类别和死因分层显示，年轻女性（55岁）的非心血管死亡率较高，女性的心血管死亡率较低。然而，这种心血管益处小于一般人群。糖尿病肾病分层显示，在所有年龄组的糖尿病妇女仍然在增加死亡率的风险与男性相比，主要归因于非心血管component.Conclusions死亡率和死亡原因在男性和女性透析随年龄的变化。非心血管死亡率的增加可以解释女性透析患者生存优势的丧失。开始透析的年轻女性和糖尿病女性的死亡风险高于同等男性。Clin J Am Soc Nephrol 6：1722-1730，2011. doi：10.2215/CJN.11331210
Background and objectives Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women.Design, setting, participants, & measurements We compared 5-year age-stratified cardiovascular and noncardiovascular mortality rates, relative risks, and hazard ratios in a European cohort of incident adult dialysis patients (European Renal Association-European Dialysis and Transplant Association [ERA-EDTA] Registry) with the European general population (Eurostat). Cause of death was recorded by ERA-EDTA codes in dialysis patients and by International Statistical Classification of Diseases codes in the general population.Results Overall, sex did not have a predictive effect on outcome in dialysis. Stratification into age categories and causes of death showed greater noncardiovascular mortality in young women (55 years), women presented lower cardiovascular mortality. This cardiovascular benefit was, however, smaller than in the general population. Stratification by diabetic nephropathy showed that diabetic women in all age categories remained at increased mortality risk compared with men, an effect mainly attributed to the noncardiovascular component.Conclusions Mortality rates and causes of death in men and women on dialysis vary with age. Increased noncardiovascular mortality may explain the loss of the survival advantage of women on dialysis. Both young and diabetic women starting dialysis are at a higher mortality risk than equal men. Clin J Am Soc Nephrol 6: 1722-1730, 2011. doi: 10.2215/CJN.11331210