Gender-Dependent Impact of Risk Factors for Cardiovascular and Non-Cardiovascular Mortality in End-Stage Renal Disease Patients on Haemodialysis

Abstract

We investigated whether mortality risk factors are gender dependent in haemodialysis patients. Patients (n = 230; 118 women, 112 men) on haemodialysis were followed for 52 months to assess the incidence of death due to cardiovascular or non-cardiovascular causes. Survival was compared by Cox regression analysis using age, diabetes, pre-existing coronary disease, troponin T and C-reactive protein as covariates. In total, 120 participants (52.2%) died within the 52 months of follow-up: 57 patients died of cardiovascular disease, 35 patients died of infectious diseases. Cox regression revealed that age, pre-existing coronary heart disease and troponin T were independent all-cause mortality risk factors for both sexes. Analyzing men and women separately revealed that diabetes and C-reactive protein seemed to be a stronger risk factors for all-cause mortality in women. Cardiovascular mortality was predicted by troponin T in women (relative risk = 5.16, 95% CI: 1.67–15.88; p = 0.004), but not in men (relative risk = 1.69; 95% CI: 0.72–3.96; p = 0.23). Our study showed for the first time that the impact of risk factors in predicting death due to cardiovascular disease is clearly gender dependent.

Cardiac troponin and C-reactive protein for predicting all-cause and cardiovascular mortality in patients with chronic kidney disease: A meta-analysis

“…One duplicate study and one study that only reported the odds ratio were also excluded. Among the included studies, 20 studies were included into the CRP analysis ( 4 , 16 , 17 ,27–43), and 17 studies were included into the cTn analysis ( 18–20 , 29 , 30 , 32 , 34 , 37 ,44–52).…”

Gender-Related Determinants of Advanced Subclinical Atherosclerosis in Patients Undergoing Kidney Transplantation

“…In general, strong evidence exists that cardiovascular risk factors and their impact could qualitatively and quantitatively differ between men and women with ESRD [27] . Similar evidence was observed in our study: predictors of advanced atherosclerosis between men and women were different, despite the similar age of both groups.…”

“…Recent recommendations for women almost do not differ from those for men [25] and thus do not fully appreciate gender differences in cardiovascular disease development and management [26] . A recent study in patients treated by hemodialysis observed greater impact of C-reactive protein and troponin T on cardiovascular and non-cardiovascular mortality in women [27] .…”