Close to 40% of deaths in young adult patients with kidney failure (ESRD) result from cardiovascular disease (CVD), according to an analysis of US Renal Data System data published in JAMA Cardiology.
Lack of preemptive transplantation and lack of pre-ESRD nephrology care are strongly associated with a higher risk of cardiovascular mortality in the 22- to 29-year-old ESRD age group, reports the study by Zubin J. Modi, MD, a pediatric nephrologist at the University of Michigan, Ann Arbor, and colleagues. They write, “We show that young adults began ESRD care with a higher burden of preexisting CVD and CVD risk factors, which may present a target for earlier intervention to improve outcomes.”
The researchers analyzed data on approximately 33,000 patients, aged 1 to 29, who started renal replacement therapy for ESRD from 2001 through 2013. About 20,000 patients were young adults, in whom ESRD onset occurred between ages 22 and 29. Their characteristics and cardiovascular outcomes were compared with those of 10,000 adolescents with incident ESRD, aged 12 to 21 years, and 3000 children aged 1 to 11 years. The researchers hypothesized that young adults in whom ESRD developed would have a different set of risk factors and higher cardiovascular morbidity and mortality compared with pediatric patients.