@article{128ac3e661884ff48691469489b74f7e,
title = "Mortality due to bleeding, myocardial infarction and stroke in dialysis patients",
abstract = "Essentials Mortality due to bleeding vs. arterial thrombosis in dialysis patients is unknown. We compared death causes of 201 918 dialysis patients with the general population. Dialysis was associated with increased mortality risks of bleeding and arterial thrombosis. Clinicians should be aware of the increased bleeding and thrombosis risks. Summary: Background Dialysis has been associated with both bleeding and thrombotic events. However, there is limited information on bleeding as a cause of death versus arterial thrombosis as a cause of death. Objectives To investigate the occurrence of bleeding, myocardial infarction and stroke as causes of death in the dialysis population as compared with the general population. Methods We included 201 918 patients from 11 countries providing data to the ERA-EDTA Registry who started dialysis treatment between 1994 and 2011, and followed them for 3 years. Age-standardized and sex-standardized mortality rate ratios for bleeding, myocardial infarction and stroke as causes of death were calculated in dialysis patients as compared with the European general population. Associations between potential risk factors and these causes of death in dialysis patients were investigated by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) by the use of Cox proportional-hazards regression. Results As compared with the general population, the age-standardized and sex-standardized mortality rate ratios in dialysis patients were 12.8 (95% CI 11.9–13.7) for bleeding as a cause of death (6.2 per 1000 person-years among dialysis patients versus 0.3 per 1000 person-years in the general population), 13.4 (95% CI 13.0–13.9) for myocardial infarction (22.5 versus 0.9 per 1000 person-years), and 12.4 (95% CI 11.9–12.9) for stroke (14.3 versus 0.7 per 1000 person-years). Conclusion Dialysis patients have highly increased risks of death caused by bleeding and arterial thrombosis as compared with the general population. Clinicians should be aware of the increased mortality risks caused by these conditions.",
keywords = "bleeding, dialysis, mortality, myocardial infarction, stroke",
author = "G. Ocak and M.L. Noordzij and Rookmaaker, {M. B.} and A. Cases and C. Couchoud and Heaf, {J. G.} and F. Jarraya and {De Meester}, J. and Groothoff, {J. W.} and Waldum-Grevbo, {B. E.} and R. Palsson and H. Resic and C. Rem{\'o}n and P. Finne and M. Stendahl and Verhaar, {M. C.} and Massy, {Z. A.} and Dekker, {F. W.} and Jager, {K. J.}",
note = "Funding Information: the ERA-EDTA Registry: Austrian Dialysis and Transplant Registry (OEDTR) (R. Kramar); Dutch-speaking Belgian Society of Nephrology (NBVN) (B. de Moor and F. Schroven); French-speaking Belgian Society of Nephrology (GNFB) (J. M. des Grottes and F. Collart); Renal Registry Bosnia and Herzgovina (L. Luki{\'c}and S. Cori{\'c}); Danish Nephrology Registry (DNS); Finnish Registry for Kidney Diseases (C. Gro€nhagen-Riska); Hellenic Renal Registry (N. Aftenakis); Icelandic End-Stage Renal Disease Registry; Norwegian Renal Registry (T. Leives-tad, A. V. Reis{\ae}ter, and A. A{\textcopyright}′ sberg); Regional Registries of Andalusia (SICATA) (P. Castro de la Nuez), Aragon (J. I. Sanchez Miret and J. M. Abad Diez), Asturias (R. Alonso de la Torre, J. R. Quir{\'o}s, and RERCA Working Group), Basque country (UNIPAR) ({\'A}. Magaz, J. Aranz-abal, M. Rodrigo, and I. Moina), Cantabria (M. Arias Rodr{\'i}guez and O. Gar{\'c}ıa Ruiz), Castile and Le{\'o}n (R. Gonz{\'a}lez and C. Fern{\'a}ndez-Renedo), Castile-La Mancha (G. Guti{\'e}rrez {\'A}vila and I. Moreno Al{\'i}a), Catalonia (RMRC) (E. Arcos, J. Comas, and J. Tort), Extremadura (J. M. Ramos Aceitero and M. A. Gar{\'c}ıa Bazaga), Galicia (E. Bouzas-Caama{\~n}o and J. S{\'a}nchez-Ib{\'a}{\~n}ez), and the Community of Madrid (M. I. Aparicio de Madre); Swedish Renal Registry (SNR) (K. G. Pru€tz, M. Evans, S. Scho€n, L. Backman, and M. Segelmark), and DutchEnd-Stage Renal Disease Registry (RENINE) (M. Hemmelder and A. Hemke). We also thank the other ERA-EDTA registry committee members not mentioned above for their advice on the analysis and the drafting of this paper: A. Wiezcek, F. C. Caskey, J. Harambat, M. Nordio, and I. Rychlik; and A. Kramer, M. Pippias, and V. S. Stel in the AMC Registry office for data collection and management. The ERA-EDTA Registry is funded by the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA). This article was written by G. Ocak, M. Noordzij, M. B. Rookmaker, A. Cases, C. Couchoud, J. G. Heaf, F. Jarraya, J. De Mee-ster, J. W. Groothoff, B. E. Waldum-Grevbo, R. Palsson, H. Resic, C. Rem{\'o}n, P. Finne, M. Stendahl, M. C. Ver-haar, Z. A. Massy, F. W. Dekker and K. J. Jageron on behalf of the ERA-EDTA Registry, which is an official body of the ERA-EDTA. Funding Information: We would like to thank the patients and staff of all of the dialysis and transplant units who have contributed data via their national and regional renal registries. Furthermore, we gratefully acknowledge the following registries and persons for their contribution to the work of the ERA-EDTA Registry: Austrian Dialysis and Transplant Registry (OEDTR) (R. Kramar); Dutch-speaking Belgian Society of Nephrology (NBVN) (B. de Moor and F. Schroven); French-speaking Belgian Society of Nephrology (GNFB) (J. M. des Grottes and F. Collart); Renal Registry Bosnia and Herzgovina (L. Luki? and S. Cori?); Danish Nephrology Registry (DNS); Finnish Registry for Kidney Diseases (C. Gr?nhagen-Riska); Hellenic Renal Registry (N. Aftenakis); Icelandic End-Stage Renal Disease Registry; Norwegian Renal Registry (T. Leivestad, A. V. Reis?ter, and A. ?sberg); Regional Registries of Andalusia (SICATA) (P. Castro de la Nuez), Aragon (J. I. Sanchez Miret and J. M. Abad Diez), Asturias (R. Alonso de la Torre, J. R. Quir?s, and RERCA Working Group), Basque country (UNIPAR) (?. Magaz, J. Aranzabal, M. Rodrigo, and I. Moina), Cantabria (M. Arias Rodr?guez and O. Garc?a Ruiz), Castile and Le?n (R. Gonz?lez and C. Fern?ndez-Renedo), Castile-La Mancha (G. Guti?rrez ?vila and I. Moreno Al?a), Catalonia (RMRC) (E. Arcos, J. Comas, and J. Tort), Extremadura (J. M. Ramos Aceitero and M. A. Garc?a Bazaga), Galicia (E. Bouzas-Caama?o and J. S?nchez-Ib??ez), and the Community of Madrid (M. I. Aparicio de Madre); Swedish Renal Registry (SNR) (K. G. Pr?tz, M. Evans, S. Sch?n, L. B?ckman, and M. Segelmark), and DutchEnd-Stage Renal Disease Registry (RENINE) (M. Hemmelder and A. Hemke). We also thank the other ERA-EDTA registry committee members not mentioned above for their advice on the analysis and the drafting of this paper: A. Wi?cek, F. C. Caskey, J. Harambat, M. Nordio, and I. Rychlik; and A. Kramer, M. Pippias, and V. S. Stel in the AMC Registry office for data collection and management. The ERA-EDTA Registry is funded by the European Renal Association?European Dialysis and Transplant Association (ERA-EDTA). This article was written by G. Ocak, M. Noordzij, M. B. Rookmaker, A. Cases, C. Couchoud, J. G. Heaf, F. Jarraya, J. De Meester, J. W. Groothoff, B. E. Waldum-Grevbo, R. Palsson, H. Resic, C. Rem?n, P. Finne, M. Stendahl, M. C. Verhaar, Z. A. Massy, F. W. Dekker and K. J. Jageron on behalf of the ERA-EDTA Registry, which is an official body of the ERA-EDTA. Publisher Copyright: {\textcopyright} 2018 International Society on Thrombosis and Haemostasis",
year = "2018",
month = oct,
doi = "10.1111/jth.14254",
language = "English",
volume = "16",
pages = "1953--1963",
journal = "Journal of Thrombosis and Haemostasis",
issn = "1538-7933",
publisher = "Wiley-Blackwell",
number = "10",
}