Comparison of causes of death using HEMO study and HCFA end-stage renal disease death notification classification systems

Rocco, Michael V.; Gao, Yan; Gassman, Jennifer; Lewis, Julia B.; Ornt, Daniel B.; Weiss, Barbara; Levey, Andrew S.

doi:10.1053/ajkd.2002.29905

Cited by 95 publications

(58 citation statements)

References 9 publications

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“…Although validation studies have shown that ESRD 2746 forms provide reasonable accuracy for the identification of fatal cardiac arrests, there still remains variation in the exact definition of cardiac arrest. 16,17 This heterogeneity may have biased our effect estimates and decreased our power to detect more granular outcomes. Although our matching included criteria to choose subjects in close geographic proximity to each other, we were not able to restrict case-control matching within the clinic, because some facilities had too few control subjects.…”

Section: Discussionmentioning

confidence: 99%

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Heritability of Risk for Sudden Cardiac Arrest in ESRD

Chan

Newton‐Cheh

Gusella

et al. 2015

Journal of the American Society of Nephrology

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Patients on dialysis are 20 times more likely to have a cardiac arrest compared with the general population. We considered whether inherited factors associate with cardiac arrest among patients on dialysis. From a sample of 647,457 patients on chronic dialysis, we identified 5117 pairs of patients who came from the same family. These patients were each matched to a control subject from the same population. McNemar's tests were used to compare the risk of cardiac arrest between the familial related and unrelated pairs. Genetically related family members who did not cohabitate had an odds ratio of 1.88 (95% confidence interval [95% CI], 1.25 to 2.84) for cardiac arrest compared with their phenotypically matched unrelated controls. Genetically related family members who lived together in the same environment had an odds ratio of 1.66 (95% CI, 1.20 to 2.28). Spouses, who are genetically unrelated but live together in the same environment, had an odds ratio of 0.95 (95% CI, 0.60 to 1.59) for cardiac arrest. The risk of cardiac arrest in patients on dialysis may be attributable to inherited factors. Additional studies are needed to identify such candidate genes that modify cardiovascular risk in ESRD.

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Section: Discussionmentioning

confidence: 99%

“…Validation studies of 2746 cardiac arrest outcomes against clinically adjudicated outcomes reported accuracy rates of 71%-84%. 16,17 The secondary outcomes of the study included all-cause mortality and noncardiovascular death.…”

Section: Study Outcomesmentioning

confidence: 99%

Heritability of Risk for Sudden Cardiac Arrest in ESRD

Chan

Newton‐Cheh

Gusella

et al. 2015

Journal of the American Society of Nephrology

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“…The protocols used for the collection and validation of outcome data have been previously described in detail (12)(13)(14). The primary outcome of the HEMO Study was all-cause mortality.…”

Section: Follow-up and Outcomesmentioning

confidence: 99%

Association between Serum β2-Microglobulin Level and Infectious Mortality in Hemodialysis Patients

Cheung

Greene

Leypoldt

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Secondary analysis of the Hemodialysis Study showed that serum ␤ 2 -microglobulin levels predicted all-cause mortality and that high-flux dialysis was associated with decreased cardiac deaths in hemodialysis patients. This study examined the association of serum ␤ 2 -microglobulin levels and dialyzer ␤ 2 -microglobulin kinetics with the two most common causes of deaths: Cardiac and infectious diseases.Cox regression analyses were performed to relate cardiac or infectious deaths to cumulative mean follow-up predialysis serum ␤ 2 -microglobulin levels while controlling for baseline demographics, comorbidity, residual kidney function, and dialysis-related variables.Results: The cohort of 1813 patients experienced 180 infectious deaths and 315 cardiac deaths. The adjusted hazard ratio for infectious death was 1.21 (95% confidence interval 1.07 to 1.37) per 10-mg/L increase in ␤ 2 -microglobulin. This association was independent of the prestudy years on dialysis. In contrast, the association between serum ␤ 2 -microglobulin level and cardiac death was not statistically significant. In similar regression models, higher cumulative mean Kt/V of ␤ 2 -microglobulin was not significantly associated with either infectious or cardiac mortality in the full cohort but exhibited trends suggesting an association with lower infectious mortality (relative risk 0.93; 95% confidence interval 0.86 to 1.01, for each 0.1-U increase in ␤ 2 -microglobulin Kt/V) and lower cardiac mortality (relative risk 0.93; 95% confidence interval 0.87 to 1.00) in the subgroup with >3.7 prestudy years of dialysis.Conclusions: These results generally support the notion that middle molecules are associated with systemic toxicity and that their accumulation predisposes dialysis patients to infectious deaths, independent of the duration of maintenance dialysis.

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“…Fatal outcome events were adjudicated by two independent physicians using a written algorithm for ASCVD cause of death ascertainment (see Table 1 for ASCVD cause of death classification codes modified from the HEMO Study [18]). The same criteria used for nonfatal events were used for fatal events.…”

Section: Data Collectionmentioning

confidence: 99%

High Lipoprotein(a) Levels and Small Apolipoprotein(a) Size Prospectively Predict Cardiovascular Events in Dialysis Patients

Longenecker¹,

Klag²,

Marcovina³

et al. 2005

Journal of the American Society of Nephrology

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, levels of which are elevated in ESRD (5). Lp(a) is composed of an LDL particle covalently bonded to apolipoprotein(a) [apo(a)], a glycoprotein with a highly variable number of Kringle-IV (K-IV) units related to a polymorphism encoded in the apo(a) gene. Lp(a) levels are inversely related to apo(a) isoform size (6).Many previous studies in the general population have found that high Lp(a) levels (7) and small apo(a) size (8 -12) are associated with ASCVD. The few studies of Lp(a) in ESRD have provided conflicting results (13-15), with the only prospective study to evaluate both Lp(a) and apo(a) size reporting that small apo(a) size but not Lp(a) level is associated with increased ASCVD (13).The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study, a prospective study of outcomes among black and white incident dialysis patients, previously found that small apo(a) size but not Lp(a) level was associated with total mortality (16). The current study, based on the CHOICE cohort, tested the a priori hypothesis that small apo(a) size but not high Lp(a) level is associated with prospectively ascertained ASCVD in a national, biracial cohort of patients who begin dialysis. Materials and Methods Study Design and PopulationThe CHOICE Study enrolled 1041 participants in 19 states from 81 dialysis clinics associated with Dialysis Clinic, Incorporated (DCI; Nashville, TN; n ϭ 923 from 79 clinics), New Haven CAPD (New Haven, CT; n ϭ 86 from one clinic), or Saint Raphael's Hospital (New Haven, CT; n ϭ 32 from one clinic) from October 1995 to June 1998. Enrollment occurred a median of 1.6 mo after first dialysis (98% within 4 mo). Blood was obtained only at the DCI clinics, and samples were available for determination of Lp(a) level and apo(a) size for 872 (93.6%) of the 923 DCI participants; 833 (90.2%) were eligible for Lp(a)-related analysis. Enrollment criteria included initiation of dialysis in the preceding 3 mo, ability to give written informed consent, age over 17 yr, and ability to speak English or Spanish. The Johns Hopkins University School of Medicine Institutional Review Board approved the protocol.

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Comparison of causes of death using HEMO study and HCFA end-stage renal disease death notification classification systems

Cited by 95 publications

References 9 publications

Heritability of Risk for Sudden Cardiac Arrest in ESRD

Heritability of Risk for Sudden Cardiac Arrest in ESRD

Association between Serum β2-Microglobulin Level and Infectious Mortality in Hemodialysis Patients

High Lipoprotein(a) Levels and Small Apolipoprotein(a) Size Prospectively Predict Cardiovascular Events in Dialysis Patients

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