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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Inflammatory markers and risk of cerebrovascularevents in patients initiating dialysis
Clinical Journal of the American Society of Nephrology, Volume 6, No. 6, Year 2011
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Description
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 withcerebrovascular events in a national US cohort of 1041 incident dialysis patients enrolled from October 1995to 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. WithCox proportional hazards regression analysis accounting for the competing risk of nonstroke death, we assessedthe independent event risk associated with baseline levels of multiple inflammatory markers (highsensitivityC-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 mayhave pleiotropic inflammatory effects.Results 165 patients experienced a cerebrovascular event during 3548 person-years of follow-up; overall incidencerate was 4.9/100 person-years. None of the inflammatory markers were associated with cerebrovascularevent risk (adjusted hazard ratios [HRs] per log unit [95% confidence interval]: hsCRP, 0.97 [0.85 to1.11]; 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 alsonot associated with significant risk of events in unadjusted (HR 1.07 [0.69 to 1.68]) or propensity-score adjustedanalyses (HR 0.98 [0.61 to 1.56]).Conclusions In conclusion, neither inflammatory markers nor statin use was associated with risk of cerebrovascularevents. Further studies are needed to understand the pathophysiology and prevention of stroke inpatients on dialysis. © 2011 by the American Society of Nephrology.
Authors & Co-Authors
Sozio, Stephen M.
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Medical Institutions
Coresh, Josef
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Medical Institutions
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Jaar, Bernard
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Medical Institutions
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
United States, Baltimore
Nephrology Center of Maryland
Fink, Nancy E.
United States, Baltimore
Johns Hopkins School of Medicine
United States, Baltimore
Johns Hopkins Medical Institutions
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Plantinga, Laura C.
United States, San Francisco
San Francisco General Hospital and Trauma Center
Armstrong, Paige A.
United States, Farmington
Uconn School of Medicine
Longenecker, Joseph Craig
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Kuwait, Kuwait City
Kuwait University
Sharrett, Albert Richey
United States, Baltimore
Johns Hopkins Medical Institutions
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Powe, Neil R.
United States, San Francisco
San Francisco General Hospital and Trauma Center
Parekh, Rulan S.
United States, Baltimore
Johns Hopkins School of Medicine
Canada, Toronto
Hospital for Sick Children University of Toronto
Statistics
Citations: 10
Authors: 10
Affiliations: 8
Identifiers
Doi:
10.2215/CJN.08350910
ISSN:
15559041
e-ISSN:
1555905X
Research Areas
Environmental
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative