Journal Mobile Options
Table of Contents
Vol. 29, No. 3, 2009
Issue release date: February 2009
Am J Nephrol 2009;29:237–243

Familiality of Cardiovascular Mortality in End-Stage Renal Disease Patients

Naiman N. · Cheung A.K. · Goldfarb-Rumyantzev A.S.
aDepartment of Biomedical Informatics, bDivision of Nephrology and Hypertension and cDialysis Program, University of Utah School of Medicine, and dMedical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, and eDivision of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


A very high rate of cardiovascular (CV) death is well recognized in individuals with end-stage renal disease (ESRD). Besides many other factors, this excess risk may also be related to familiality. We tested this hypothesis by estimating the risk of CV death among both ESRD patients and their relatives. In this case-control study, we used the Utah Population Database (UPDB), which includes genealogy records, state-wide death certificates as well as other data sets. These have been linked to the University of Utah Health Sciences Enterprise Data Warehouse which provides multiple diagnosis data sources. Patients with ESRD either on dialysis or who received a kidney transplant were identified in the clinical databases at the University of Utah Dialysis Program and Kidney Transplant Program or from Utah death certificates. CV deaths were identified by the reporting on the death certificates. The relative risks for CV death, adjusted for several potential confounders in the ESRD patients (n = 516) and in their first-degree (n = 2,418) and second-degree (n = 7,720) relatives were estimated in relation to the general population. Using information from death certificates, ESRD patients were found to have disproportionately increased risk for CV mortality (relative risk or RR = 2.4; 95% CI 2.11–2.72), compared to the general population. First-degree relatives of ESRD patients were also found to have an increased CV mortality risk (RR = 1.10; 95% CI 1.01–1.20). When the specific categories of CVD were analyzed, the first-degree relatives also had higher risks for death from acute myocardial infarction (RR = 1.20; 95% CI 1.03–1.40) or heart failure (RR = 1.32; 95% CI 1.12–1.56). An increased risk for CV mortality was, however, not observed in second-degree relatives of ESRD patients, except for the subcategory of hypertensive heart disease (RR = 1.24, 95% CI 1.01–1.49). In conclusion, this study suggests that, in addition to many putative risk factors, the increased risk of CV death in ESRD patients may have a familial contribution.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Foley RN, Parfrey PS, Sarnak MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112–S119.
  2. Valderrabano F, Jones EH, Mallick NP: Report on management of renal failure in Europe, XXIV, 1993. Nephrol Dial Transplant 1995;10(suppl 5):1–25.

    External Resources

  3. Goldfarb-Rumyantzev AS, Baird BC, Leypoldt JK, et al: The association between BP and mortality in patients on chronic peritoneal dialysis. Nephrol Dial Transplant 2005;20:1693–1701.
  4. Habib AN, Baird BC, Leypoldt JK, et al: The association of lipid levels with mortality in patients on chronic peritoneal dialysis. Nephrol Dial Transplant, 2006.
  5. Port FK, Hulbert-Shearon TE, Wolfe RA, et al: Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients. Am J Kidney Dis 1999;33:507–517.
  6. Zager PG, Nikolic J, Brown RH, et al: ‘U’ curve association of blood pressure and mortality in hemodialysis patients. Medical Directors of Dialysis Clinic, Inc. Kidney Int 1998;54:561–569.
  7. Horan PG, Kamaruddin MS, Moore MJ, et al: Cardiovascular disease risk profiles among ‘healthy’ siblings of patients with early-onset cardiovascular disease: application of the new SCORE system. Eur J Cardiovasc Prev Rehabil 2007;14:521–525.
  8. Wright CE, O’Donnell K, Brydon L, et al: Family history of cardiovascular disease is associated with cardiovascular responses to stress in healthy young men and women. Int J Psychophysiol 2007;63:275–282.
  9. Satko SG, Sedor JR, Iyengar SK, et al: Familial clustering of chronic kidney disease. Semin Dial 2007;20:229–236.
  10. Goldfarb-Rumyantzev AS, Cheung AK, Habib AN, et al: A population-based assessment of the familial component of chronic kidney disease mortality. Am J Nephrol 2006;26:142–148.
  11. Robin NH, Tabereaux PB, Benza R, et al: Genetic testing in cardiovascular disease. J Am Coll Cardiol 2007;50:727–737.
  12. Skolnick M: Cancer Incidence in Defined Populations; in Cairns JLL, SkolnickM (eds): The Utah Genealogical Data Base: A Resource for Genetic Epidemiology. (vol Banbury Report No.4). New York, Cold Spring Harbor Laboratory Press, 1980, pp 285–297.
  13. Cannon-Albright LA, Thomas A, Goldgar DE, et al: Familiality of cancer in Utah. Cancer Res 1994;54:2378–2385.
  14. Cannon-Albright LA, Camp NJ, Farnham JM, et al: A genealogical assessment of heritable predisposition to aneurysms. J Neurosurg 2003;99:637–643.
  15. Anderson RN, Rosenberg HM: Disease classification: measuring the effect of the Tenth Revision of the International Classification of Diseases on cause-of-death data in the United States. Stat Med 2003;22:1551–1570.
  16. Israel RA: The history of the International Classification of Diseases. Health Bull (Edinb) 1991;49:62–66.
  17. Mesler DE, Byrne-Logan S, McCarthy EP, et al: How much better can we predict dialysis patient survival using clinical data? Health Serv Res 1999;34:365–375.
  18. Collins AJ, Li S, Ma JZ, et al: Cardiovascular disease in end-stage renal disease patients. Am J Kidney Dis 2001;38:S26–S29.
  19. Williams RR, Hunt SC, Heiss G, et al: Usefulness of cardiovascular family history data for population-based preventive medicine and medical research (the Health Family Tree Study and the NHLBI Family Heart Study). Am J Cardiol 2001;87:129–135.
  20. McLellan T, Jorde LB, Skolnick MH: Genetic distances between the Utah Mormons and related populations. Am J Hum Genet 1984;36:836–857.
  21. Jorde LB, Skolnick MH: Demographic and genetic application of computerized record linking: the Utah Mormon genealogy. Information Sci Hum 1981;56–57:105–117.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50