Researchers at Mayo Clinic studied over 15,000 patients who received heart stents to open blocked arteries, comparing those with healthy kidneys to those on dialysis (a treatment for failed kidneys). Over 10 years, patients on dialysis were nearly 4 times more likely to die from any cause and almost 5 times more likely to die from heart problems. While most deaths weren’t directly from heart disease, heart-related deaths were still much more common in the dialysis group. This research helps doctors understand that dialysis patients need extra careful monitoring and heart care after receiving stents.
The Quick Take
- What they studied: How well heart stent procedures work for patients on dialysis compared to patients with healthy kidneys, and what causes deaths in these groups over 10 years
- Who participated: 15,403 patients who received heart stents between 2009 and 2023. Of these, 369 were on dialysis (average age 66) and 1,659 had moderate to severe kidney disease. Dialysis patients were younger but had more other health problems.
- Key finding: Dialysis patients were nearly 4 times more likely to die within 10 years and almost 5 times more likely to die from heart problems compared to patients with normal kidney function. About 39% of dialysis patients’ deaths were heart-related, compared to 24% in patients with healthy kidneys.
- What it means for you: If you’re on dialysis and need a heart stent, understand that your risks are higher than someone with healthy kidneys. This means you’ll need closer follow-up care, more frequent doctor visits, and careful management of your heart health. Talk to your doctor about what extra monitoring you might need.
The Research Details
This was a retrospective study, meaning researchers looked back at medical records of patients who had already received heart stents. They divided 15,403 patients into four groups based on how well their kidneys worked: normal kidney function, mild-to-moderate kidney disease, moderate-to-severe kidney disease, and those on dialysis. Researchers then tracked these patients for up to 10 years, recording deaths and health problems. They used advanced statistical methods to account for differences between groups, like age and other health conditions, so they could fairly compare outcomes.
The researchers determined causes of death by reviewing medical records, death certificates, autopsy reports, and calling families when needed. This careful approach helped them understand not just whether patients died, but why they died—whether from heart problems or other causes.
This study design is important because it uses real-world data from actual patients over a long time period, rather than a short-term experiment. By following patients for 10 years, researchers could see long-term effects that might not appear in shorter studies. The careful tracking of causes of death helps doctors understand the specific risks dialysis patients face, which can guide treatment decisions.
This study has several strengths: it included a large number of patients (over 15,000), followed them for a long time (10 years), and carefully determined causes of death. However, because it looked back at existing records rather than randomly assigning patients to treatments, we can’t be completely certain that dialysis itself caused the higher death rates—other unmeasured factors could play a role. The researchers did use statistical methods to account for known differences between groups, which strengthens the findings.
What the Results Show
Dialysis patients had dramatically worse outcomes after heart stents. Over 10 years, dialysis patients were 3.84 times more likely to die from any cause compared to patients with normal kidney function. When looking specifically at heart-related deaths, the difference was even larger—dialysis patients were 4.95 times more likely to die from heart problems.
Dialysis patients also experienced more major heart problems (2.32 times higher risk) and were hospitalized more often (2.14 times higher risk). Interestingly, dialysis patients were younger on average (66 years old vs. 69 years old), but had more other health conditions, which may have contributed to their worse outcomes.
When researchers looked at what caused deaths, they found something important: while most deaths in all groups weren’t directly from heart disease, heart-related deaths were much more common in dialysis patients. In the dialysis group, 39% of deaths were heart-related, compared to only 24% in patients with normal kidneys. This suggests that while dialysis patients face many health challenges, heart problems remain a major threat.
Dialysis patients needed repeat procedures to open blocked arteries again at higher rates, though this difference wasn’t quite statistically significant. The high rate of hospitalization in dialysis patients (2.14 times higher) suggests they had more complications and health problems overall. The fact that dialysis patients were younger but had worse outcomes indicates that kidney failure itself, rather than just age, is a major risk factor for poor heart outcomes.
Previous research has shown that kidney disease increases heart disease risk, but this study provides detailed long-term data specifically for patients receiving heart stents. The findings align with what doctors already knew—that kidney disease is a major risk factor for heart problems—but quantify the risk more precisely and show that even after receiving stents, dialysis patients remain at very high risk. The focus on causes of death is particularly valuable, as it shows that heart problems remain a leading cause of death in this group despite treatment.
This study looked back at medical records rather than randomly assigning patients to different treatments, so we can’t be completely certain that dialysis itself caused the worse outcomes—other factors we didn’t measure could be involved. The study was done at one hospital system (Mayo Clinic), so results might be different at other hospitals or in different populations. Some information about causes of death came from phone interviews and family reports, which might not be as accurate as medical records. Finally, medical care has improved over the study period, so results from 2009 might not apply to patients treated today.
The Bottom Line
If you’re on dialysis and need a heart stent, work closely with your cardiologist (heart doctor) and nephrologist (kidney doctor) to manage your heart health. This includes taking all prescribed medications, attending all follow-up appointments, controlling blood pressure and cholesterol, and reporting any chest pain or shortness of breath immediately. The evidence strongly suggests (high confidence) that dialysis patients need more intensive heart monitoring and care than patients with healthy kidneys.
This research is most important for dialysis patients who need heart stents or are at risk for heart disease. It’s also relevant for their family members, caregivers, and healthcare providers. If you have kidney disease but aren’t on dialysis yet, this research highlights the importance of managing your kidney health to prevent progression. People with normal kidney function don’t need to change their behavior based on this study.
Heart problems in dialysis patients can develop quickly, so benefits from careful management may appear within weeks to months (better symptom control, fewer hospitalizations). However, the major benefit—reducing death risk—takes years to measure. Most importantly, start managing your heart health now rather than waiting to see results, as prevention is more effective than treatment.
Want to Apply This Research?
- If you’re on dialysis with a heart stent, track daily: blood pressure readings (morning and evening), any chest pain or shortness of breath episodes, medications taken, and appointment attendance. Set reminders for all cardiology and nephrology appointments.
- Use the app to set daily reminders for taking heart medications on time, log blood pressure readings before and after dialysis sessions, and create a checklist for pre-appointment preparation (list of symptoms, questions for doctors, recent medication changes).
- Review your blood pressure trends weekly and share monthly summaries with your doctors. Flag any sudden increases in blood pressure or new symptoms immediately. Track hospitalizations and emergency visits to identify patterns. Use the app to maintain a medication list and update it whenever prescriptions change.
This research shows that dialysis patients who receive heart stents have higher risks of death and heart problems compared to patients with healthy kidneys. However, this doesn’t mean heart stents are ineffective for dialysis patients—they may still be necessary and life-saving. If you’re on dialysis and have been recommended for a heart stent, discuss both the benefits and risks with your cardiologist. This study should not discourage you from getting needed heart treatment, but rather motivate you to work closely with your medical team for intensive monitoring and management. Always consult with your healthcare providers before making any decisions about your treatment.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.