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March 28, 1974New England Journal of Medicine1,794 citations

Accelerated Atherosclerosis in Prolonged Maintenance Hemodialysis

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ALArmando LindnerBCBernard CharraDSDonald J. Sherrard

Key Points

  • To assess long-term survival, mortality, and the incidence of arteriosclerotic cardiovascular complications in patients undergoing prolonged maintenance hemodialysis.
  • Followed a cohort of N=39 patients receiving regular maintenance hemodialysis initiated in 1960 (mean baseline age: 37.0 ± 9.5 years).
  • Monitored survival and cardiovascular morbidity over a follow-up duration of up to 13 years (mean duration of treatment: 6.5 years, range 1 to 13 years).
  • Overall mortality was 56.4% (23 of 39 patients) by the end of the 13-year follow-up period.
  • Arteriosclerotic complications caused 14 of 23 deaths (60.9%), comprising myocardial infarction (n=8), stroke (n=3), and refractory congestive heart failure (n=3).
  • The incidence of arteriosclerotic complications was markedly higher than in age-matched normal and hypertensive controls, mirroring rates observed in Type 2 hyperlipoproteinemia.

Abstract

The survival experience of 39 patients receiving long-term regular hemodialysis in Seattle since 1960 was studied with particular reference to mortality and morbidity from arteriosclerotic cardiovascular complications. Mean age (± 1 S.D.) was 37.0 ± 9.5 years for the group at the start of dialysis. Mean duration of treatment was 6.5 years (range, one to 13). Overall mortality was 56.4 per cent at the end of the 13-year follow-up period, and 14 of 23 deaths could be attributed to arteriosclerotic complications: myocardial infarction was responsible for eight, strokes for three, and refractory congestive heart failure for three deaths. The incidence of these complications was many times higher than for normal and hypertensive groups of comparable age, and similar to rates found in Type 2 hyperlipoproteinemia. These results indicate that accelerated atherosclerosis is a major risk to long-term survivors on maintenance hemodialysis. (N Engl J Med 290:697–701, 1974)

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Cite This Study

Lindner et al. (1974) studied this question.

synapsesocial.com/papers/6a0d6e3b1e1a6dfdb4ba8f81https://doi.org/10.1056/nejm197403282901301
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