Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients
Background/Aims: Traditional cardiovascular (CV) risk factors (RFs) and their management targets may not be applicable to specific medical subpopulations, particularly dialysis patients. This study aimed to evaluate the dose-response association between measurements of RFs, cardiovascular mortality,...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2018-04-01
|
| Series: | Kidney & Blood Pressure Research |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/489289 |
| _version_ | 1811193689195675648 |
|---|---|
| author | Xiaoxue Zhang Dahai Yu Yamei Cai Jin Shang Rui Qin Jing Xiao Xing Tian Zhanzheng Zhao David Simmons |
| author_facet | Xiaoxue Zhang Dahai Yu Yamei Cai Jin Shang Rui Qin Jing Xiao Xing Tian Zhanzheng Zhao David Simmons |
| author_sort | Xiaoxue Zhang |
| collection | DOAJ |
| description | Background/Aims: Traditional cardiovascular (CV) risk factors (RFs) and their management targets may not be applicable to specific medical subpopulations, particularly dialysis patients. This study aimed to evaluate the dose-response association between measurements of RFs, cardiovascular mortality, and potential metabolic targets among Chinese patients initializing peritoneal dialysis (PD). Methods: Risk-set sampling was applied to two population based 1: 10 case-control studies of incident PD patients, matched by age, sex and the year of initialisation of PD: a main sample (204 cases and 2,040 controls) and a replication sample (81 cases and 810 controls). The dose-response association between continuous measurements of CV RFs (blood pressure, fasting glucose, body mass index, total cholesterol, phosphate and ejection fraction) at baseline and the 2-year CV mortality were analyzed using conditional Logistic regression. The final threshold was chosen based upon a significant break in the regression coefficients and achievement of the minimum Bayesian information criterion (BIC). Results: A linear relationship was identified between fasting glucose and CV mortality. Non-linear associations between other measurements and CV mortality suggested potential metabolic treatment intensification thresholds as < 145/92mmHg for blood pressure, < 1.70mmol/L for phosphate, 24 kg/m2 for body mass index, 4.6mmol/L for total cholesterol, and > 60% for ejection fraction respectively. Conclusion: Our findings highlight the potential importance of more intensive glucose management, anti-hypertensive treatment and dietary management among PD patients. We recommend that the clinical relevance of these epidemiological associations be tested using randomized controlled trials of multifaceted interventions. |
| first_indexed | 2024-04-12T00:13:49Z |
| format | Article |
| id | doaj.art-6eb7cf42ff744a52b27c240a56ed8cc7 |
| institution | Directory Open Access Journal |
| issn | 1420-4096 1423-0143 |
| language | English |
| last_indexed | 2024-04-12T00:13:49Z |
| publishDate | 2018-04-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney & Blood Pressure Research |
| spelling | doaj.art-6eb7cf42ff744a52b27c240a56ed8cc72022-12-22T03:55:54ZengKarger PublishersKidney & Blood Pressure Research1420-40961423-01432018-04-0143262863810.1159/000489289489289Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis PatientsXiaoxue ZhangDahai YuYamei CaiJin ShangRui QinJing XiaoXing TianZhanzheng ZhaoDavid SimmonsBackground/Aims: Traditional cardiovascular (CV) risk factors (RFs) and their management targets may not be applicable to specific medical subpopulations, particularly dialysis patients. This study aimed to evaluate the dose-response association between measurements of RFs, cardiovascular mortality, and potential metabolic targets among Chinese patients initializing peritoneal dialysis (PD). Methods: Risk-set sampling was applied to two population based 1: 10 case-control studies of incident PD patients, matched by age, sex and the year of initialisation of PD: a main sample (204 cases and 2,040 controls) and a replication sample (81 cases and 810 controls). The dose-response association between continuous measurements of CV RFs (blood pressure, fasting glucose, body mass index, total cholesterol, phosphate and ejection fraction) at baseline and the 2-year CV mortality were analyzed using conditional Logistic regression. The final threshold was chosen based upon a significant break in the regression coefficients and achievement of the minimum Bayesian information criterion (BIC). Results: A linear relationship was identified between fasting glucose and CV mortality. Non-linear associations between other measurements and CV mortality suggested potential metabolic treatment intensification thresholds as < 145/92mmHg for blood pressure, < 1.70mmol/L for phosphate, 24 kg/m2 for body mass index, 4.6mmol/L for total cholesterol, and > 60% for ejection fraction respectively. Conclusion: Our findings highlight the potential importance of more intensive glucose management, anti-hypertensive treatment and dietary management among PD patients. We recommend that the clinical relevance of these epidemiological associations be tested using randomized controlled trials of multifaceted interventions.https://www.karger.com/Article/FullText/489289Risk factorCardiovascular diseasesMortalityPeritoneal dialysis |
| spellingShingle | Xiaoxue Zhang Dahai Yu Yamei Cai Jin Shang Rui Qin Jing Xiao Xing Tian Zhanzheng Zhao David Simmons Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients Kidney & Blood Pressure Research Risk factor Cardiovascular diseases Mortality Peritoneal dialysis |
| title | Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients |
| title_full | Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients |
| title_fullStr | Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients |
| title_full_unstemmed | Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients |
| title_short | Dose-Response Between Cardiovascular Risk Factors and Cardiovascular Mortality Among Incident Peritoneal Dialysis Patients |
| title_sort | dose response between cardiovascular risk factors and cardiovascular mortality among incident peritoneal dialysis patients |
| topic | Risk factor Cardiovascular diseases Mortality Peritoneal dialysis |
| url | https://www.karger.com/Article/FullText/489289 |
| work_keys_str_mv | AT xiaoxuezhang doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT dahaiyu doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT yameicai doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT jinshang doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT ruiqin doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT jingxiao doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT xingtian doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT zhanzhengzhao doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients AT davidsimmons doseresponsebetweencardiovascularriskfactorsandcardiovascularmortalityamongincidentperitonealdialysispatients |