Risk factors associated with subendocardial ischemia in hemodialysis patients

Abstract Background and Aims Age and chronic kidney disease have been described as mortality risk factors for coronavirus disease 2019 (COVID-19). Currently, an important percentage of patients in hemodialysis are elderly. This study aimed to investigate the impact of COVID-19 in this population and to determine risk factors associated with mortality. Method Data was obtained from the Spanish COVID-19 CKD Working Group Registry, that included patients in renal replacement therapy (dialysis and kidney transplantation) infected by COVID-19. From March 18, 2020, to August 27, 2020, 1165 patients on hemodialysis affected by COVID-19 were included in the Registry. A total of 328 patients were under 65 years-old and 837 were 65 years old or older (elderly group). Results Mortality was 18.6% higher (95% confidence interval (CI): 13.8%-23.4%) in the elderly hemodialysis patients compared to the non-elderly group (see figure). Death from COVID-19 infection was increased 5.5-fold in hemodialysis patients compared to mortality in the general population for a similar period, and there was an age-associated mortality increase in both populations (see figure 1). In multivariate Cox regression analysis, age (hazard ratio (HR) 1.58, 95% CI: 1.31-1.92), dyspnea at presentation (HR 1.61, 95% CI: 1.20-2.16), pneumonia (HR 1.76, 95% CI: 1.12-2.75) and admission to hospital (HR 4.13, 95% CI: 1.92-8.88) were identified as independent mortality risk factors in the elderly hemodialysis population. Treatment with glucocorticoids reduced the risk of death (HR 0.71, 95% CI: 0.51-0.98) in aged patients on hemodialysis. Conclusion Mortality is dramatically increased in elderly hemodialysis patients affected by COVID-19. Age, dyspnea at presentation, pneumonia or hospitalization are factors associated with a worse prognosis, after adjusting dialysis population to other confounding factors. Treatment with glucocorticoids could be a therapeutic option for this specific population.

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Prevalence, genotypes and risk factors associated with hepatitis C virus infection in hemodialysis patients in Campo Grande, MS, Brazil

Memórias do Instituto Oswaldo Cruz ◽

10.1590/s0074-02762008000400016 ◽

2008 ◽

Vol 103 (4) ◽

pp. 405-408 ◽

Cited By ~ 12

Author(s):

Solange Z Freitas ◽

Rivaldo V da Cunha ◽

Regina MB Martins ◽

Sheila A Teles ◽

Mary L Ibanhes ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Hemodialysis Patients ◽

Hepatitis C Virus Infection ◽

Factors Associated

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Risk factors associated with substance use

PsycEXTRA Dataset ◽

10.1037/e553882014-001 ◽

2014 ◽

Author(s):

Ariel M. Barber ◽

Alexandra Crouch ◽

Stephen Campbell

Keyword(s):

Risk Factors ◽

Substance Use ◽

Factors Associated

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A Six Year Prospective Study of Fibrinogen and Other Risk Factors Associated with Mortality in Stable Claudicants

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656361 ◽

1992 ◽

Vol 68 (03) ◽

pp. 261-263 ◽

Cited By ~ 71

Author(s):

A K Banerjee ◽

J Pearson ◽

E L Gilliland ◽

D Goss ◽

J D Lewis ◽

...

Keyword(s):

Risk Factors ◽

Intermittent Claudication ◽

Fibrinogen Level ◽

Past History ◽

Fold Increase ◽

Arterial Disease ◽

Plasma Fibrinogen ◽

Plasma Fibrinogen Level ◽

Factors Associated ◽

Probability Of Death

SummaryA total of 333 patients with stable intermittent claudication at recruitment were followed up for 6 years to determine risk factors associated with subsequent mortality. Cardiovascular diseases were the underlying cause of death in 78% of the 114 patients who died. The strongest independent predictor of death during the follow-up period was the plasma fibrinogen level, an increase of 1 g/l being associated with a nearly two-fold increase in the probability of death within the next 6 years. Age, low ankle/brachial pressure index and a past history of myocardial infarction also increased the probability of death during the study period. The plasma fibrinogen level is a valuable index of those patients with stable intermittent claudication at high risk of early mortality. The results also provide further evidence for the involvement of fibrinogen in the pathogenesis of arterial disease.

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