Cardiovascular disease (CVD) is a major complication among patients with end-stage renal disease (ESRD). However, the risk of cardiovascular outcomes in young adults with ESRD may vary. This study aims to investigate the risk of CVD and mortality in young adults with ESRD.

This population-based cohort study included a total of 33,156 patients aged 1-29 years with ESRD. The cardiovascular outcomes in the participants were evaluated with adjusted proportional hazard models. The primary outcome of the study was adverse cardiovascular outcomes, including cardiovascular mortality and hospitalization.

Among young adults (22-29 years), the 1-year cardiovascular hospitalization rate was 138 per 1,000 patient-years. The findings suggested that young adults were at higher risk of cardiovascular hospitalization than children (HR 0.41) and adolescents (HR 0.86). 1,577 (39.1%) deaths out of a total of 4,038 deaths among young adults were due to CVD. The 5-year cumulative incidence of mortality was 7.3% in the young adults’ group, which was higher than in adolescents (4.0%) and children (1.7%). The higher risk of hospitalization and mortality in all three groups was associated with the lack of preemptive transplants compared with hemodialysis and peritoneal dialysis.

The research concluded that cardiovascular disease was a major complication in young adults with ESRD, accounting for nearly 40% of deaths.