| Age, race, diabetes, blood pressure, and mortality among hemodialysis patients. | |
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MedLine Citation:
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PMID: 20947632 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Orrin B Myers; Christopher Adams; Mark R Rohrscheib; Karen S Servilla; Dana Miskulin; Edward J Bedrick; Philip G Zager |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-14 |
Journal Detail:
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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:
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Created Date: 2010-11-01 Completed Date: 2010-11-22 Revised Date: 2011-11-01 |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1970-8 Citation Subset: IM |
Affiliation:
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University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5271, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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J Am Soc Nephrol. 2010 Nov;21(11):1816-8
[PMID:
20947629
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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