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All New Dialysis Patients at Increased Risk of Death

TUESDAY, Oct. 27 -- A higher risk of cardiovascular-related death isn't the reason why kidney failure patients starting dialysis are at increased risk of death, according to new research that challenges previous thinking.

A number of studies have found that cardiovascular disease accounts for 40 percent to 50 percent of deaths in patients with end-stage kidney disease, and "it is believed that the life span of patients receiving dialysis is reduced mainly as a consequence of premature cardiovascular death," noted the authors of the new study.

Using data from between January 1994 and January 2007, the researchers compared the death rates in 123,407 dialysis patients in Europe and in the general European population.

Among dialysis patients, non-cardiovascular causes accounted for 50.8 percent of deaths while cardiovascular disease caused 39.1 percent of deaths. In the general population, 58.4 percent of deaths were from non-cardiovascular causes, 40.4 percent were from cardiovascular causes, and 1.2 percent were from unknown causes.

The overall all-cause death rate was higher among patients on dialysis, according to the report published in the Oct. 28 issue of the Journal of the American Medical Association.

"In particular, non-cardiovascular mortality rates were higher than cardiovascular mortality rates in patients starting dialysis," wrote Dinanda J. de Jager, of the Leiden University Medical Center in the Netherlands, and colleagues. "These results suggest that excess mortality in patients receiving dialysis is not specifically the result of increased cardiovascular deaths."

The researchers concluded that "cardiovascular and non-cardiovascular mortality are equally increased during the first three years of dialysis, compared with the general population. This implies that the importance of non-cardiovascular mortality in patients receiving dialysis has generally been underestimated. Therefore, research should focus more on methods to prevent non-cardiovascular mortality."

More information

The National Kidney Foundation has more about dialysis.

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Posted: October 2009