Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Kidney Blood Press Res 2008;31:360–366 DOI: 10.1159/000173718 Gender-Dependent Impact of Risk Factors for Cardiovascular and Non-Cardiovascular Mortality in End-Stage Renal Disease Patients on Haemodialysis Berthold Hocher a Philipp Kalk a, b Michael Godes a Lutz Liefeldt c Reinhard Ziebig d Johannes-Peter Stasch e, g Thomas Quaschning f Thiemo Pfab a, b a Center for Cardiovascular Research/Department of Pharmacology, and Departments of Nephrology, b Campus Benjamin Franklin and c Campus Mitte, and d Institute of Clinical Chemistry, Charité, Berlin, e Cardiovascular Research, Bayer Health Care, Wuppertal, f Department of Nephrology, University of Freiburg, Freiburg, and g Martin-Luther-University, School of Pharmacy, Halle, Germany men (relative risk = 1.69; 95% CI: 0.72–3.96; p = 0.23). Our study showed for the first time that the impact of risk factors in predicting death due to cardiovascular disease is clearly gender dependent. Copyright © 2008 S. Karger AG, Basel Introduction Although haemodialysis techniques have improved considerably in the past decades, the excess mortality of patients on haemodialysis treatment represents an as yet unsolved clinical issue. Despite complex guidelines that have been introduced in clinical practice in the USA and in Europe, the outcome remains poor [1–3]. Cardiovas- cular disease (sudden cardiac death, heart failure and atherothrombotic disease) is the most common cause of death in the haemodialysis population, followed by infec- tious diseases [4–6] . Key Words Haemodialysis  Troponin T  C-reactive protein  Cardiovascular mortality Abstract We investigated whether mortality risk factors are gender dependent in haemodialysis patients. Patients (n = 230; 118 women, 112 men) on haemodialysis were followed for 52 months to assess the incidence of death due to cardiovascu- lar or non-cardiovascular causes. Survival was compared by Cox regression analysis using age, diabetes, pre-existing cor- onary disease, troponin T and C-reactive protein as covari- ates. In total, 120 participants (52.2%) died within the 52 months of follow-up: 57 patients died of cardiovascular dis- ease, 35 patients died of infectious diseases. Cox regression revealed that age, pre-existing coronary heart disease and troponin T were independent all-cause mortality risk factors for both sexes. Analyzing men and women separately re- vealed that diabetes and C-reactive protein seemed to be a stronger risk factors for all-cause mortality in women. Car- diovascular mortality was predicted by troponin T in women (relative risk = 5.16, 95% CI: 1.67–15.88; p = 0.004), but not in Received: July 7, 2008 Accepted: October 16, 2008 Published online: November 20, 2008 Prof. Dr. Berthold Hocher Center for Cardiovascular Research/Institute of Pharmacology Charité, Hessische Str. 3–4 DE–10115 Berlin (Germany) Tel. +49 30 450 514 098, Fax +49 30 450 514 938, E-Mail berthold.hocher@charite.de © 2008 S. Karger AG, Basel 1420–4096/08/0315–0360$24.50/0 Accessible online at: www.karger.com/kbr B.H. and P.K. contributed equally to the study.