American journal of kidney diseases : the official journal of the National Kidney Foundation · 2002
History of myocardial infarction and stroke among incident end-stage renal disease cases and population-based controls: an analysis of shared risk factors.
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Muntner Paul, Coresh Josef, Klag Michael J, Whelton Paul K, Perneger Thomas V
Аннотация
BACKGROUND: A history of myocardial infarction (MI) and stroke is more common among incident cases of treated end-stage renal disease (ESRD) than in the general US population.
METHODS: Whether this association is the result of shared risk factors or renal dysfunction before ESRD was examined using data from a population-based case-control study of 716 incident patients with ESRD and 361 control subjects of similar age from Maryland, Virginia, West Virginia, and Washington, DC. Medical history including a previous MI and stroke, and dates of these events were obtained by means of a structured telephone interview.
RESULTS: After adjustment for age, race, and sex, odds of ESRD were 3.6 (95% confidence interval [CI], 2.0 to 6.5) and 11.1 (95% CI, 4.3 to 28.6) times greater for those with versus without a history of MI and stroke, respectively. Adjustment for long-standing hypertension, diabetes mellitus, and several other potential confounders reduced the odds ratio (OR) of ESRD for those with a history of MI by 77% (OR, 1.6; 95% CI, 0.7 to 3.3) and 39% (OR, 7.2; 95% CI, 2.2 to 23.2) for those with a history of stroke. The OR for ESRD was higher within 5 years of an MI (OR, 2.2; 95% CI, 0.8 to 6.1) or stroke (OR, 14.9; 95% CI, 1.8 to 125) than for more distant MI (OR, 0.8; 95% CI, 0.2 to 2.5) and stroke (OR, 4.5; 95% CI, 1.0 to 19.0) events.
CONCLUSION: The high prevalence of a history of MI at ESRD incidence is explained primarily by shared risk factors, but the high prevalence of stroke is not.
METHODS: Whether this association is the result of shared risk factors or renal dysfunction before ESRD was examined using data from a population-based case-control study of 716 incident patients with ESRD and 361 control subjects of similar age from Maryland, Virginia, West Virginia, and Washington, DC. Medical history including a previous MI and stroke, and dates of these events were obtained by means of a structured telephone interview.
RESULTS: After adjustment for age, race, and sex, odds of ESRD were 3.6 (95% confidence interval [CI], 2.0 to 6.5) and 11.1 (95% CI, 4.3 to 28.6) times greater for those with versus without a history of MI and stroke, respectively. Adjustment for long-standing hypertension, diabetes mellitus, and several other potential confounders reduced the odds ratio (OR) of ESRD for those with a history of MI by 77% (OR, 1.6; 95% CI, 0.7 to 3.3) and 39% (OR, 7.2; 95% CI, 2.2 to 23.2) for those with a history of stroke. The OR for ESRD was higher within 5 years of an MI (OR, 2.2; 95% CI, 0.8 to 6.1) or stroke (OR, 14.9; 95% CI, 1.8 to 125) than for more distant MI (OR, 0.8; 95% CI, 0.2 to 2.5) and stroke (OR, 4.5; 95% CI, 1.0 to 19.0) events.
CONCLUSION: The high prevalence of a history of MI at ESRD incidence is explained primarily by shared risk factors, but the high prevalence of stroke is not.