Document Detail


Age, race, diabetes, blood pressure, and mortality among hemodialysis patients.
MedLine Citation:
PMID:  20947632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Observational studies involving hemodialysis patients suggest a U-shaped relationship between BP and mortality, but the majority of these studies followed large, heterogeneous cohorts. To examine whether age, race, and diabetes status affect the association between systolic BP (SBP; predialysis) and mortality, we studied a cohort of 16,283 incident hemodialysis patients. We constructed a series of multivariate proportional hazards models, adding age and BP to the analyses as cubic polynomial splines to model potential nonlinear relationships with mortality. Overall, low SBP associated with increased mortality, and the association was more pronounced among older patients and those with diabetes. Higher SBP associated with increased mortality among younger patients, regardless of race or diabetes status. We observed a survival advantage for black patients primarily among older patients. Diabetes associated with increased mortality mainly among older patients with low BP. In conclusion, the design of randomized clinical trials to identify optimal BP targets for patients with ESRD should take age and diabetes status into consideration.
Authors:
Orrin B Myers; Christopher Adams; Mark R Rohrscheib; Karen S Servilla; Dana Miskulin; Edward J Bedrick; Philip G Zager
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-14
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  21     ISSN:  1533-3450     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-11-22     Revised Date:  2011-11-01    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1970-8     Citation Subset:  IM    
Affiliation:
University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5271, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group
Age Factors
Aged
Aged, 80 and over
Blood Pressure / physiology
Cohort Studies
Comorbidity
Continental Population Groups*
Diabetes Mellitus / epidemiology,  ethnology*,  physiopathology
European Continental Ancestry Group
Female
Follow-Up Studies
Humans
Hypertension / epidemiology,  ethnology*,  physiopathology
Kidney Failure, Chronic / epidemiology,  ethnology*,  mortality*,  therapy
Male
Middle Aged
Proportional Hazards Models
Renal Dialysis*
Risk Factors
Survival Rate
Comments/Corrections
Comment In:
J Am Soc Nephrol. 2010 Nov;21(11):1816-8   [PMID:  20947629 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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