Increased risk of cardiovascular events in end-stage renal disease patients with osteoporosis: a nationwide population-based cohort study

被引:12
作者
Yu, T. -M. [1 ,2 ,3 ]
Lin, C. -L. [7 ,8 ]
Shu, K. -H. [3 ]
Liu, Y. -L. [4 ,5 ,6 ]
Chen, C. -H. [3 ]
Huang, S. -T. [3 ]
Kao, C. -H. [1 ,2 ,9 ,10 ]
机构
[1] China Med Univ Hosp, Coll Med, Sch Med, Taichung 404, Taiwan
[2] China Med Univ Hosp, Grad Inst Clin Med, Taichung 404, Taiwan
[3] Taichung Vet Gen Hosp, Div Nephrol, Taichung, Taiwan
[4] China Med Univ Hosp, Div Nephrol, Taichung, Taiwan
[5] China Med Univ Hosp, Kidney Inst, Taichung, Taiwan
[6] China Med Univ, Sch Med, Taichung, Taiwan
[7] China Med Univ Hosp, Management Off Hlth Data, Taichung, Taiwan
[8] China Med Univ, Coll Med, Taichung, Taiwan
[9] China Med Univ Hos, Dept Nucl Med, Taichung, Taiwan
[10] China Med Univ Hos, PET Ctr, Taichung, Taiwan
关键词
Cardiovascular events; End-stage renal disease; Nationwide population-based cohort study; Osteoporosis; CHRONIC KIDNEY-DISEASE; BONE-MINERAL DENSITY; HEMODIALYSIS-PATIENTS; VASCULAR AXIS; CALCIFICATION; ASSOCIATION; PHYSIOLOGY; STIFFNESS; MORTALITY; CALCIUM;
D O I
10.1007/s00198-014-2982-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We investigated the cardiovascular disease risk and mortality in end-stage renal disease (ESRD) patients. A total of 12,535 patients with ESRD undergoing incident dialysis were enrolled, 4,153 (33.13 %) of whom had osteoporosis. The osteoporosis group was associated with a significantly higher risk of coronary artery disease, congestive heart failure, stroke, and mortality. In this study, we aimed to investigate the risk of cardiovascular disease and mortality in a sample of end-stage renal disease patients with osteoporosis. We conducted this retrospective cohort study of incident dialysis patients with and without osteoporosis to evaluate the risk of overall mortality and cardiovascular complications including stroke, coronary heart disease, and congestive heart failure between the two groups. A total of 12,535 patients with ESRD undergoing incident dialysis were enrolled, 4,153 (33.13 %) of whom had osteoporosis, from the National Health Insurance Research Database of Taiwan for the years 1998 through 2011. The osteoporosis group had more comorbidities than the group without osteoporosis including hypertension, hyperlipidemia, mental disorders, and hepatitis C infection. After adjusting for age, gender, and related comorbidities, the osteoporosis group was associated with a significantly higher risk of coronary artery disease (hazard ratio (HR) = 1.32, 95 % confidence interval (CI) = 1.20-1.45) which was significant in both genders (women, HR = 1.35, 95 % CI = 1.20-1.50; men HR = 1.27, 95 % CI = 1.06-1.52) and all age groups (a parts per thousand currency sign49 years HR = 1.41, 95 % CI = 1.16-1.70; > 49 years HR = 1.30, 95 % CI = 1.16-1.45). Similar results were observed for the outcomes of congestive heart failure, stroke, and mortality. The results showed that osteoporosis was significantly associated with the subsequent risk of cardiovascular events in patients with ESRD. When encountering patients with ESRD and osteoporosis, physicians should be alert to the subsequent cardiovascular risk in incident dialysis patients to prevent the subsequent occurrence of these adverse events.
引用
收藏
页码:785 / 793
页数:9
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