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April 21, 2004

Inflammation, Cholesterol Levels, and Risk of Mortality Among Patients Receiving Dialysis

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(15):1833-1834. doi:10.1001/jama.291.15.1834-a

To the Editor: We are concerned that the sample of Dr Liu and colleagues1 may not be representative of US patients who receive dialysis. The median age of patients receiving incident dialysis in the United States is 64.5 years,2 whereas in the study by Liu et al it was 57.2 years for all patients and 53.7 years for those without malnutrition-inflammation complex syndrome (MICS). The renal transplant rate in the US dialysis population is approximately 5.5 per 100 patient-years.2 One would thus expect 103 in the cohort of Liu et al, but this is substantially fewer than the 153 the authors reported. Hence, the younger age and the higher transplant rate in this study indicate a dialysis population that is substantially healthier than average.