Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)

Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD). Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investiga...

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Veröffentlicht in:Kidney international 2003-08, Vol.64 (2), p.579-584
Hauptverfasser: Zoccali, Carmine, Mallamaci, Francesca, Tripepi, Giovanni, Parlongo, Saverio, Cutrupi, Sebastiano, Benedetto, Frank Antonio, Bonanno, Grazia, Seminara, Giuseppe, Fatuzzo, Pasquale, Rapisarda, Francesco, Malatino, Lorenzo Salvatore
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container_issue 2
container_start_page 579
container_title Kidney international
container_volume 64
creator Zoccali, Carmine
Mallamaci, Francesca
Tripepi, Giovanni
Parlongo, Saverio
Cutrupi, Sebastiano
Benedetto, Frank Antonio
Bonanno, Grazia
Seminara, Giuseppe
Fatuzzo, Pasquale
Rapisarda, Francesco
Malatino, Lorenzo Salvatore
description Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD). Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months). On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77). seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.
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Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months). On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77). seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. 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Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months). On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77). seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. 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Cross-sectional and retrospective studies suggest that Chlamydia pneumoniae infection may contribute importantly to the high cardiovascular risk of patients with end-stage renal disease (ESRD). We investigated the relationship between C. pneumoniae serology and survival and incident fatal cardiovascular events in a cohort of 227 ESRD patients (follow-up of 39 ± 20months). On univariate Cox regression analysis patients with anti-C. pneumoniae immunogloblulin A (IgA) titer ≥1:16 had a significantly higher risk of all-cause and cardiovascular mortality when compared to patients without IgA antibodies. However, after data adjustment for age and smoking, the hazard ratio (HR) decreased substantially and became largely nonsignificant. Adjustments for traditional and nontraditional risk factors further decreased the independent association of IgA anti-C. pneumoniae and these outcomes (all-cause mortality HR, 1.08; 95% CI, 0.68 to 1.72; P = 0.74; cardiovascular mortality HR, 1.07; 95% CI, 0.60 to 1.89; P = 0.83). A similar loss of prognostic power was observed for IgG anti-C. pneumoniae so that in fully adjusted models the HRs were very close to those observed for IgA anti-C. pneumoniae (all-cause mortality HR, 1.13; 95% CI, 0.68 to 1.86, P = 0.64; cardiovascular mortality HR, 1.10; 95% CI, 0.60 to 2.00; P = 0.77). seropositivity is associated to shorter survival and incident fatal cardiovascular events in patients with ESRD but these associations are in large part attributable to the link between C. pneumoniae and well-established, traditional risk factors. It is highly unlikely that C. pneumoniae infection is a major risk factor in patients with ESRD.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12846753</pmid><doi>10.1046/j.1523-1755.2003.00095.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Antibodies, Bacterial - blood
Biological and medical sciences
Cardiovascular Diseases - mortality
cardiovascular risk
chlamydia
Chlamydophila Infections - mortality
Chlamydophila pneumoniae
Chlamydophila pneumoniae - immunology
Cohort Studies
dialysis
ESRD
Female
Follow-Up Studies
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Kidney Failure, Chronic - mortality
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Renal failure
Risk Factors
survival
Survival Analysis
uremia
title Chlamydia pneumoniae, overall and cardiovascular mortality in end-stage renal disease (ESRD)
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