Document Detail

Mortality due to pulmonary embolism, myocardial infarction, and stroke among incident dialysis patients.
MedLine Citation:
PMID:  22970891     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is has been suggested that dialysis patients have lower mortality rates for pulmonary embolism than the general population, because of platelet dysfunction and bleeding tendency. However, there is limited information whether dialysis is indeed associated with a decreased mortality risk from pulmonary embolism.
OBJECTIVE: The aim of our study was to evaluate whether mortality rate ratios for pulmonary embolism were lower than for myocardial infarction and stroke in dialysis patients compared with the general population.
METHODS: Cardiovascular causes of death for 130,439 incident dialysis patients registered in the ERA-EDTA Registry were compared with the cardiovascular causes of death for the European general population.
RESULTS: The age- and sex-standardized mortality rate (SMR) from pulmonary embolism was 12.2 (95% CI 10.2-14.6) times higher in dialysis patients than in the general population. The SMRs in dialysis patients compared with the general population were 11.0 (95% CI 10.6-11.4) for myocardial infarction, 8.4 (95% CI 8.0-8.8) for stroke, and 8.3 (95% CI 8.0-8.5) for other cardiovascular diseases. In dialysis patients, primary kidney disease due to diabetes was associated with an increased mortality risk due to pulmonary embolism (HR 1.9; 95% CI 1.0-3.8), myocardial infarction (HR 4.1; 95% CI 3.4-4.9), stroke (HR 3.5; 95% CI 2.8-4.4), and other cardiovascular causes of death (HR 3.4; 95% CI 2.9-3.9) compared with patients with polycystic kidney disease.
CONCLUSIONS: Dialysis patients were found to have an unexpected highly increased mortality rate for pulmonary embolism and increased mortality rates for myocardial infarction and stroke.
G Ocak; K J van Stralen; F R Rosendaal; M Verduijn; P Ravani; R Palsson; T Leivestad; A J Hoitsma; M Ferrer-Alamar; P Finne; J De Meester; C Wanner; F W Dekker; K J Jager
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  10     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  2013-06-05     Revised Date:  2013-08-27    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  2484-93     Citation Subset:  IM    
Copyright Information:
© 2012 International Society on Thrombosis and Haemostasis.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Cohort Studies
Myocardial Infarction / mortality*
Pulmonary Embolism / mortality*
Renal Dialysis*
Stroke / mortality*
Comment In:
J Thromb Haemost. 2013 Jun;11(6):1207-8   [PMID:  23557154 ]
J Thromb Haemost. 2012 Dec;10(12):2481-3   [PMID:  23110427 ]

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