Key result
The increase in ischemic heart disease mortality among diabetic Pima Indians from 3.3 to 6.3 deaths/1,000 person-years disappeared (P=0.57) after accounting for access to renal replacement therapy.
Why the study?
Does access to renal replacement therapy explain the increase in ischemic heart disease mortality rates in diabetic Pima Indians?
Cohort (n=2,095)
Does access to renal replacement therapy explain the increase in ischemic heart disease mortality rates in diabetic Pima Indians?
Absolute Event Rate: 6.3% vs 3.3%
p-value: p=0.03
The emergence of ischemic heart disease as the leading cause of death in diabetic Pima Indians is largely attributable to the availability of renal replacement therapy preventing earlier death from diabetic nephropathy.
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Highlights competing risks when interpreting diabetes mortality trends; leaves open whether renal replacement therapy similarly shifts causes of death in other cohorts.
Pavkov et al. (2004) conducted a cohort in Diabetes (n=2,095). Access to renal replacement therapy (RRT) vs. Historical time periods was evaluated on Ischemic heart disease (IHD) death rate (deaths/1,000 person-years) (p=0.03). The increase in ischemic heart disease mortality among diabetic Pima Indians from 3.3 to 6.3 deaths/1,000 person-years disappeared (P=0.57) after accounting for access to renal replacement therapy.
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