Mortality rates declining among dialysis patients despite rise in coronary artery disease, study finds

A new study led by researchers at the University of Limerick’s Graduate Entry Medical School has found that deaths among dialysis patients are falling despite a rise in coronary artery disease. Better cardiovascular care in the general population prior to dialysis could explain, in part, the decline in mortality, researchers speculate. This international study was led by Professor Austin Stack, Consultant Nephrologist, University Hospital Limerick and Professor of Medicine at the Graduate Entry Medical School in UL.

The research evaluated changes in the patterns of coronary artery disease and associated mortality in over 800,000 dialysis patients in the US. The study found that the prevalence of coronary artery disease among dialysis patients is increasing for men and women and across almost all race groups.

Professor Stack explained the significance of the study; “In Ireland, we have almost 1, 800 people currently receiving dialysis and this number is set to increase by 3-6 % year on year. Understanding the burden of disease in the population and the clinical outcomes is vital to any healthcare system-including Ireland. Our research has allowed us to examine in detail the frequency and outcomes of coronary artery disease in the US dialysis population. An increasing burden of coronary artery disease will not only adversely impact the individual; it will also place a huge burden on existing and future health resources.”

Professor Stack added; "Most dialysis patients will die from a cardiovascular-related condition and this study helps us to better understand their long-term outlook and the effectiveness of conventional treatment practices.  The study has shown improvements in the survival of dialysis patients with coronary artery disease, albeit modest, despite advancing age and an increasing burden of medical conditions which they experience. If the fall in death rates is also replicated in Ireland, this indeed would be very welcome news.”

“While we all welcome these findings, we should not get too complacent and take our foot of the pedal” cautioned Professor Stack. “The mortality rates for patients with coronary disease who reach end stage kidney disease remain unacceptably high and much works needs to be done. Highlighting the importance of cardiovascular and kidney health remains an important goal for all health professionals who care for these patients in order to achieve better outcomes.”

Source: http://www.ul.ie/