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Abstract: PO1045

Risk Factors and Mortality in Dialysis Patients with Abdominal Aortic Aneurysm

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Xia, Di, Augusta University, Augusta, Georgia, United States
  • Linder, Daniel F., Augusta University, Augusta, Georgia, United States
  • Waller, Jennifer L., Augusta University, Augusta, Georgia, United States
  • Bollag, Wendy B., Augusta University, Augusta, Georgia, United States
  • Mohammed, Azeem Abdul, Augusta University, Augusta, Georgia, United States
  • Padala, Sandeep A., Augusta University, Augusta, Georgia, United States
  • Nahman, N. Stanley, Augusta University, Augusta, Georgia, United States
  • Kheda, Mufaddal, Augusta University, Augusta, Georgia, United States
  • Baer, Stephanie L., Augusta University, Augusta, Georgia, United States
  • Taskar, Varsha S., Augusta University, Augusta, Georgia, United States
  • Weintraub, Neal, Augusta University, Augusta, Georgia, United States
  • Siddiqui, Budder, Augusta University, Augusta, Georgia, United States
Background

In the general population, abdominal aortic aneurysm (AAA) is associated with increased mortality. Once diagnosed, AAA can be followed noninvasively or corrected surgically. Vascular disease is common in dialysis patients, but there is limited information on the incidence and outcomes for AAA in this population. To address this question, we queried the United States Renal Data System (USRDS) for risk factors associated with diagnosis of AAA, survival of patients diagnosed with AAA, and overall risk factors for mortality.

Methods

Incident dialysis patients from 2005–2014 from the USRDS were queried. ICD-9 and ICD-10 codes were used to define a diagnosis of AAA and identify clinical co-morbidities. Cox proportional hazards (CPH) modeling was used to determine the adjusted hazard ratio (aHR) and 95% confidence intervals (CI) for death.

Results

From a total cohort of 868,799, we identified 22,121 subjects with a diagnosis of AAA. When compared to patients without the diagnosis, AAA patients were older and had higher percentages of white race, male gender, tobacco use, Charleson comorbidity index (CCI), and hypertension as end stage renal disease (ESRD) etiology, but lower percentages of diabetes as ESRD etiology. A bivariate CPH model of survival showed that AAA patients had significantly increased mortality compared to patients without a AAA diagnosis (HR=1.29, p-value<0.0001). However, in the final CPH model, patients with a AAA diagnosis had a decreased risk of mortality (aHR=0.85, 95% CI 0.844–0.860), after controlling for age, CCI, and other demographic and comorbid variables.

Conclusion

ESRD patients with a diagnosis of AAA are more likely to be older, white, male, smokers with hypertension as the cause of ESRD. Patients with AAA are less likely to have diabetes as an etiology of ESRD. AAA is associated with a decreased risk of death, which suggests that AAA in the ESRD population by itself may not increase mortality, but the comorbid factors that come with it do.

Funding

  • Private Foundation Support