Journal article
Inflammatory Markers and Risk of Cerebrovascular Events in Patients Initiating Dialysis
Clinical journal of the American Society of Nephrology, v 6(6), pp 1292-1300
01 Jun 2011
PMID: 21551022
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background and objectives Stroke remains a leading cause of morbidity and mortality for patients on dialysis; however, its risk factors in this population and measures to prevent it are not well understood.
Design, setting, participants, & measurements We investigated whether inflammation was associated with cerebrovascular events in a national US cohort of 1041 incident dialysis patients enrolled from October 1995 to June 1998 and followed until January 31, 2004. Incident cerebrovascular events were defined as nonfatal (hospitalized stroke, carotid endarterectomy) and fatal (stroke death) events after dialysis initiation. With Cox proportional hazards regression analysis accounting for the competing risk of nonstroke death, we assessed the independent event risk associated with baseline levels of multiple inflammatory markers (high-sensitivity C-reactive protein [hsCRP], interleukin-6 (IL-6), matrix metalloproteinase-3 [MMP-3], and P-selectin) and hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) use, which may have pleiotropic inflammatory effects.
Results 165 patients experienced a cerebrovascular event during 3548 person-years of follow-up; overall incidence rate was 4.9/100 person-years. None of the inflammatory markers were associated with cerebrovascular event risk (adjusted hazard ratios [HRs] per log unit [95% confidence interval]: hsCRP, 0.97 [0.85 to 1.11]; IL-6, 1.04 [0.85 to 1.26]; MMP-3, 1.02 [0.70 to 1.48]; P-selectin, 0.98 [0.57 to 1.68]). Statin use was also not associated with significant risk of events in unadjusted (HR 1.07 [0.69 to 1.681) or propensity-score adjusted analyses (HR 0.98 [0.61 to 1.56]).
Conclusions In conclusion, neither inflammatory markers nor statin use was associated with risk of cerebrovascular events. Further studies are needed to understand the pathophysiology and prevention of stroke in patients on dialysis. Clin J Am Soc Nephrol 6: 1292-1300, 2011. doi: 10.2215/CJN.08350910
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Details
- Title
- Inflammatory Markers and Risk of Cerebrovascular Events in Patients Initiating Dialysis
- Creators
- Stephen M. Sozio - Johns Hopkins MedicineJosef Coresh - Johns Hopkins UniversityBernard C. Jaar - MED InstituteNancy E. Fink - Johns Hopkins UniversityLaura C. Plantinga - San Francisco General HospitalPaige A. Armstrong - University of ConnecticutJ. Craig Longenecker - Johns Hopkins UniversityA. Richey Sharrett - Johns Hopkins UniversityNeil R. Powe - San Francisco General HospitalRulan S. Parekh - University Health Network
- Publication Details
- Clinical journal of the American Society of Nephrology, v 6(6), pp 1292-1300
- Publisher
- Amer Soc Nephrology
- Number of pages
- 9
- Grant note
- U01DK057304; R01DK072367; RO1DK059616 / National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) R01HS008365 / Agency for Health Care Research and Quality; United States Department of Health & Human Services; Agency for Healthcare Research & Quality National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA National Kidney Foundation of Maryland KL2RR025006 / National Center for Research Resources; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) RO1HL62985 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000291500900011
- Scopus ID
- 2-s2.0-79958200250
- Other Identifier
- 991022052304004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Urology & Nephrology