Cardiovascular Event Rates Among Hemodialysis Patients Across Geographical Regions—A Snapshot From The Dialysis Outcomes and Practice Patterns Study (DOPPS)

التفاصيل البيبلوغرافية
العنوان:	Cardiovascular Event Rates Among Hemodialysis Patients Across Geographical Regions—A Snapshot From The Dialysis Outcomes and Practice Patterns Study (DOPPS)
المؤلفون:	Heide A. Stirnadel-Farrant, Angelo Karaboyas, Borut Cizman, Brian A. Bieber, Lata Kler, Delyth Jones, Alexander R. Cobitz, Bruce M. Robinson
المصدر:	Kidney International Reports, Vol 4, Iss 6, Pp 864-872 (2019)
بيانات النشر:	Elsevier, 2019.
سنة النشر:	2019
المجموعة:	LCC:Diseases of the genitourinary system. Urology
مصطلحات موضوعية:	Diseases of the genitourinary system. Urology, RC870-923
الوصف:	Introduction: Cardiovascular (CV) morbidity and mortality are excessively high among hemodialysis (HD) patients. Anemia is a common complication of chronic kidney disease (CKD) and a known risk factor for CV events. To understand the impact of the recent regulatory and guideline changes in anemia management, we examined regional CV event rates in high-risk and erythropoiesis-stimulating agent (ESA)−hyporesponsive HD patients. Methods: A prospective cohort study including 16,560 HD patients, 8660 CV high-risk, and 884 hyporesponsive to ESAs, from the Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 4 (2009−2011) and phase 5 (2012−2015) was conducted to quantify all-cause mortality, major adverse cardiovascular events (MACE), and MACE plus heart failure and thromboembolic events (MACE+). Results: The MACE+ rates (per 100 patient-years) were highest in North America (NA) (19.4; 95% CI = 18.2−20.7), followed by Europe (EU) (17.4; 95% CI = 16.6−18.1) and lowest in Japan (7.5; 95% CI = 6.9−8.1). When restricted to the high CV risk population, rates increased by 36% in NA, 45% in EU, and 72% in Japan. Mortality accounted for >74% of MACE+ events. MACE+ rates in ESA-hyporesponsive patients and high CV risk patients were similar in NA and EU cohorts. There were minimal differences in outcomes between the DOPPS phases 4 and 5. Conclusion: Cardiovascular event rates are high in the HD population, vary by geographic region, and are substantially higher in high CV risk patients and ESA-hyporesponsive patients; however, the rates appear not to be affected by anemia guideline changes. The findings from this study will be essential to contextualize the design of future CV anemia-related outcome studies and clinical trials. Keywords: cardiovascular events, cohort study, DOPPS, ESA hyporesponsivness, hemodialysis
نوع الوثيقة:	article
وصف الملف:	electronic resource
اللغة:	English
تدمد:	2468-0249
Relation:	http://www.sciencedirect.com/science/article/pii/S2468024919301214; https://doaj.org/toc/2468-0249
DOI:	10.1016/j.ekir.2019.03.016
URL الوصول:	https://doaj.org/article/87864e505ec240ba80546f280000f9ec
رقم الانضمام:	edsdoj.87864e505ec240ba80546f280000f9ec
قاعدة البيانات:	Directory of Open Access Journals

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