2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2004080661v1 16/5/1420    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Parekh, R. S. Articles by Klag, M. J. Search for Related Content PubMed PubMed Citation Articles by Parekh, R. S. Articles by Klag, M. J.

Incidence of Atherosclerosis by Race in the Dialysis Morbidity and Mortality Study: A Sample of the US ESRD Population

Rulan S. Parekh^*,, Lin Zhang, Barbara A. Fivush^* and Michael J. Klag^,,

^* Pediatrics; Medicine, School of Medicine, and Departments of; Epidemiology; and Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

Address correspondence to: Dr. Rulan S. Parekh, Division of Pediatric Nephrology, Johns Hopkins University, 600 North Wolfe Street, Park 336, Baltimore, MD, 21287-2535; Phone: 410-955-2467; Fax: 410-614-3680; rsparekh{at}jhmi.edu

Received for publication August 11, 2004. Accepted for publication February 14, 2005.

White individuals who are on dialysis experience much higher overall and cardiovascular mortality rates than black individuals despite a more favorable risk factor profile, but the incidence of nonfatal cardiovascular disease (CVD) to this racial disparity has not been well studied. A longitudinal study of 16,103 people who had ESRD and were enrolled in the United Renal Data System from 1993 to 1996 was conducted. The incidence of new and recurrent atherosclerotic CVD (ASCVD) events was determined using Medicare claims for hospitalizations and mortality among blacks and whites, stratified by ASCVD at baseline. ASCVD was defined as coronary heart disease, peripheral vascular disease, and cerebrovascular disease. Incidence of new ASCVD in people without ASCVD at baseline was 146.9 per 1000 person-years in whites and 118.7 per 1000 person-years in blacks. Incidence of recurrent ASCVD was 404.1 per 1000 person-years in whites and 317.5 per 1000 person-years in blacks. Whites were 1.35 (95% confidence interval, 1.18 to 1.55) times more likely to develop incident ASCVD compared with blacks and 1.25 (95% confidence interval, 1.14 to 1.36) times more likely to develop recurrent disease after adjusting for traditional CVD and dialysis-related risk factors. Excess risk for recurrent ASCVD in whites compared with blacks was consistently present no matter the duration of dialysis: Hazard ratio 1.42 for 0 to 6 mo and 1.40 for 6 to 12 mo. Whites who are treated with dialysis have a higher incidence of ASCVD than blacks who are on dialysis, both new and recurrent. Although differences in survival before the initiation of dialysis may contribute to the observed difference in ASCVD risk, it is not explained by baseline traditional and dialysis-related ASCVD risk factors.

This article has been cited by other articles:

				P.C. Bennett, S. Silverman, P.S. Gill, and G.Y.H. Lip Ethnicity and peripheral artery disease QJM, January 1, 2009; 102(1): 3 - 16. [Abstract] [Full Text] [PDF]

				S. Rajagopalan, S. Dellegrottaglie, A. L. Furniss, B. W. Gillespie, S. Satayathum, N. Lameire, A. Saito, T. Akiba, M. Jadoul, N. Ginsberg, et al. Peripheral Arterial Disease in Patients With End-Stage Renal Disease: Observations From the Dialysis Outcomes and Practice Patterns Study (DOPPS) Circulation, October 31, 2006; 114(18): 1914 - 1922. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673