Mortality from infections and malignancies in patients treated with renal replacement therapy: data from the ERA-EDTA registry
- Author
- Judith L Vogelzang, Karlijn J van Stralen, Marlies Noordzij, Jose Abad Diez, Juan J Carrero, Cecile Couchoud, Friedo W Dekker, Patrik Finne, Denis Fouque, James G Heaf, Andries Hoitsma, Torbjørn Leivestad, Johan de Meester, Wendy Metcalfe, Runolfur Palsson, Maurizio Postorino, Pietro Ravani, Raymond Vanholder (UGent) , Manfred Wallner, Christoph Wanner, Jaap W Groothoff and Kitty J Jager
- Organization
- Abstract
- Background. Infections and malignancies are the most common non-cardiovascular causes of death in patients on chronic renal replacement therapy (RRT). Here, we aimed to quantify the mortality risk attributed to infections and malignancies in dialysis patients and kidney transplant recipients when compared with the general population by age group and sex. Methods. We followed 168 156 patients included in the ERA-EDTA registry who started RRT in 1993-2007 until 1 January 2012. Age-and cause-specific mortality rates per 1000 person-years (py) and mortality rate ratios (MRRs) compared with the European general population (WHO) were calculated. To identify risk factors, we used Cox regression. Results. Infection-related mortality was increased 82-fold in dialysis patients and 32-fold in transplant recipients compared with the general population. Female sex, diabetes, cancer and multisystem disease were associated with an increased risk of infection-related mortality. The sex difference was most pronounced for dialysis patients aged 0-39 years, with women having a 32% (adjusted HR 1.32 95% CI 1.09-1.60) higher risk of infection-related mortality than men. Mortality from malignancies was 2.9 times higher in dialysis patients and 1.7 times higher in transplant recipients than in the general population. Cancer and multisystem disease as primary causes of end-stage renal disease were associated with higher mortality from malignancies. Conclusion. Infection-related mortality is highly increased in dialysis and kidney transplant patients, while the risk of malignancy-related death is moderately increased. Young women on dialysis may deserve special attention because of their high excess risk of infection-related mortality. Further research into the mechanisms, prevention and optimal treatment of infections in this vulnerable population is required.
- Keywords
- mortality, transplantation, malignancies, infections, dialysis, CHRONIC KIDNEY-DISEASE, HEMODIALYSIS-PATIENTS, DIALYSIS PATIENTS, VASCULAR ACCESS, NONCARDIOVASCULAR MORTALITY, TRANSPLANT RECIPIENTS, GENERAL-POPULATION, GENDER-DIFFERENCES, STARTING DIALYSIS, WOMEN
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-7095446
- MLA
- Vogelzang, Judith L., et al. “Mortality from Infections and Malignancies in Patients Treated with Renal Replacement Therapy: Data from the ERA-EDTA Registry.” NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 30, no. 6, 2015, pp. 1028–37, doi:10.1093/ndt/gfv007.
- APA
- Vogelzang, J. L., van Stralen, K. J., Noordzij, M., Abad Diez, J., Carrero, J. J., Couchoud, C., … Jager, K. J. (2015). Mortality from infections and malignancies in patients treated with renal replacement therapy: data from the ERA-EDTA registry. NEPHROLOGY DIALYSIS TRANSPLANTATION, 30(6), 1028–1037. https://doi.org/10.1093/ndt/gfv007
- Chicago author-date
- Vogelzang, Judith L, Karlijn J van Stralen, Marlies Noordzij, Jose Abad Diez, Juan J Carrero, Cecile Couchoud, Friedo W Dekker, et al. 2015. “Mortality from Infections and Malignancies in Patients Treated with Renal Replacement Therapy: Data from the ERA-EDTA Registry.” NEPHROLOGY DIALYSIS TRANSPLANTATION 30 (6): 1028–37. https://doi.org/10.1093/ndt/gfv007.
- Chicago author-date (all authors)
- Vogelzang, Judith L, Karlijn J van Stralen, Marlies Noordzij, Jose Abad Diez, Juan J Carrero, Cecile Couchoud, Friedo W Dekker, Patrik Finne, Denis Fouque, James G Heaf, Andries Hoitsma, Torbjørn Leivestad, Johan de Meester, Wendy Metcalfe, Runolfur Palsson, Maurizio Postorino, Pietro Ravani, Raymond Vanholder, Manfred Wallner, Christoph Wanner, Jaap W Groothoff, and Kitty J Jager. 2015. “Mortality from Infections and Malignancies in Patients Treated with Renal Replacement Therapy: Data from the ERA-EDTA Registry.” NEPHROLOGY DIALYSIS TRANSPLANTATION 30 (6): 1028–1037. doi:10.1093/ndt/gfv007.
- Vancouver
- 1.Vogelzang JL, van Stralen KJ, Noordzij M, Abad Diez J, Carrero JJ, Couchoud C, et al. Mortality from infections and malignancies in patients treated with renal replacement therapy: data from the ERA-EDTA registry. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2015;30(6):1028–37.
- IEEE
- [1]J. L. Vogelzang et al., “Mortality from infections and malignancies in patients treated with renal replacement therapy: data from the ERA-EDTA registry,” NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 30, no. 6, pp. 1028–1037, 2015.
@article{7095446, abstract = {{Background. Infections and malignancies are the most common non-cardiovascular causes of death in patients on chronic renal replacement therapy (RRT). Here, we aimed to quantify the mortality risk attributed to infections and malignancies in dialysis patients and kidney transplant recipients when compared with the general population by age group and sex. Methods. We followed 168 156 patients included in the ERA-EDTA registry who started RRT in 1993-2007 until 1 January 2012. Age-and cause-specific mortality rates per 1000 person-years (py) and mortality rate ratios (MRRs) compared with the European general population (WHO) were calculated. To identify risk factors, we used Cox regression. Results. Infection-related mortality was increased 82-fold in dialysis patients and 32-fold in transplant recipients compared with the general population. Female sex, diabetes, cancer and multisystem disease were associated with an increased risk of infection-related mortality. The sex difference was most pronounced for dialysis patients aged 0-39 years, with women having a 32% (adjusted HR 1.32 95% CI 1.09-1.60) higher risk of infection-related mortality than men. Mortality from malignancies was 2.9 times higher in dialysis patients and 1.7 times higher in transplant recipients than in the general population. Cancer and multisystem disease as primary causes of end-stage renal disease were associated with higher mortality from malignancies. Conclusion. Infection-related mortality is highly increased in dialysis and kidney transplant patients, while the risk of malignancy-related death is moderately increased. Young women on dialysis may deserve special attention because of their high excess risk of infection-related mortality. Further research into the mechanisms, prevention and optimal treatment of infections in this vulnerable population is required.}}, author = {{Vogelzang, Judith L and van Stralen, Karlijn J and Noordzij, Marlies and Abad Diez, Jose and Carrero, Juan J and Couchoud, Cecile and Dekker, Friedo W and Finne, Patrik and Fouque, Denis and Heaf, James G and Hoitsma, Andries and Leivestad, Torbjørn and de Meester, Johan and Metcalfe, Wendy and Palsson, Runolfur and Postorino, Maurizio and Ravani, Pietro and Vanholder, Raymond and Wallner, Manfred and Wanner, Christoph and Groothoff, Jaap W and Jager, Kitty J}}, issn = {{0931-0509}}, journal = {{NEPHROLOGY DIALYSIS TRANSPLANTATION}}, keywords = {{mortality,transplantation,malignancies,infections,dialysis,CHRONIC KIDNEY-DISEASE,HEMODIALYSIS-PATIENTS,DIALYSIS PATIENTS,VASCULAR ACCESS,NONCARDIOVASCULAR MORTALITY,TRANSPLANT RECIPIENTS,GENERAL-POPULATION,GENDER-DIFFERENCES,STARTING DIALYSIS,WOMEN}}, language = {{eng}}, number = {{6}}, pages = {{1028--1037}}, title = {{Mortality from infections and malignancies in patients treated with renal replacement therapy: data from the ERA-EDTA registry}}, url = {{http://doi.org/10.1093/ndt/gfv007}}, volume = {{30}}, year = {{2015}}, }
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