Table 3.

Risk of outcomes in white compared with black patients of the HEMO study stratified by quintiles of TMAO

OutcomesRange, µMNEventsIR Per 1000 PYModel 1Model 2Model 3Model 4
HR (95% CI)P ValueHR (95% CI)P ValueHR (95% CI)P ValueHR (95% CI)P Value
Cardiac death
 Quintile 12.25–56.22463758.91.49 (0.93 to 2.40)0.101.50 (0.91 to 2.47)0.111.71 (1.00 to 2.92)0.051.70 (1.00 to 2.89)0.05
 Quintile 256.3–76.72484672.90.92 (0.50 to 1.68)0.790.87 (0.46 to 1.65)0.660.96 (0.51 to 1.79)0.890.98 (0.52 to 1.86)0.95
 Quintile 376.8–1002434063.11.89 (1.03 to 3.46)0.041.83 (1.01 to 3.34)0.052.08 (1.17 to 3.69)0.012.12 (1.21 to 3.69)0.01
 Quintile 4101–1342515381.42.80 (1.70 to 4.62)<0.0012.62 (1.56 to 4.41)<0.0013.27 (2.08 to 5.13)<0.0013.29 (2.10 to 5.17)<0.001
 Quintile 5135–6822444063.43.74 (2.54 to 5.50)<0.0013.65 (2.42 to 5.52)<0.0013.94 (2.48 to 6.27)<0.0013.89 (2.47 to 6.13)<0.001
P trend<0.001<0.001<0.001<0.001
Sudden cardiac death
 Quintile 12.25–56.22461930.21.02 (0.38 to 2.75)0.971.06 (0.40 to 2.75)0.911.15 (0.45 to 2.95)0.781.14 (0.45 to 2.93)0.78
 Quintile 256.3–76.72482031.70.86 (0.36 to 2.04)0.720.81 (0.32 to 2.07)0.670.85 (0.33 to 2.21)0.750.87 (0.32 to 2.35)0.78
 Quintile 376.8–1002432539.41.43 (0.74 to 2.76)0.291.38 (0.70 to 2.75)0.361.47 (0.73 to 2.96)0.2811.49 (0.74 to 3.01)0.27
 Quintile 4101–1342513553.82.66 (1.60 to 4.41)<0.0012.55 (1.48 to 4.41)<0.0012.84 (1.78 to 4.52)<0.0012.86 (1.80 to 4.55)<0.001
 Quintile 5135–6822442539.64.15 (2.14 to 8.04)<0.0014.08 (2.14 to 7.79)<0.0013.98 (2.12 to 7.50)<0.0013.95 (2.15 to 7.25)<0.001
P trend<0.001<0.001<0.001<0.001
First cardiovascular event or any-cause death
 Quintile 12.25–56.2225121276.90.92 (0.61 to 1.39)0.700.97 (0.61 to 1.53)0.890.91 (0.61 to 1.35)0.650.91 (0.61 to 1.36)0.66
 Quintile 256.3–76.7232120262.11.50 (1.02 to 2.21)0.041.49 (1.08 to 2.06)0.021.56 (1.19 to 2.04)0.0011.55 (1.19 to 2.02)0.001
 Quintile 376.8–100229115240.31.85 (1.27 to 2.69)0.0011.85 (1.26 to 2.71)0.0021.77 (1.23 to 2.53)0.0021.75 (1.22 to 2.51)0.002
 Quintile 4101–134235134280.81.34 (1.05 to 1.73)0.021.28 (1.00 to 1.64)0.051.37 (1.12 to 1.67)0.0021.36 (1.12 to 1.66)0.002
 Quintile 5135–682227136314.81.43 (1.09 to 1.87)0.011.45 (1.09 to 1.94)0.011.29 (0.93 to 1.79)0.121.30 (0.94 to 1.80)0.12
P trend0.330.300.470.46
Any-cause death
 Quintile 12.25–56.2246111176.61.20 (0.85 to 1.69)0.301.20 (0.85 to 1.70)0.301.14 (0.87 to 1.50)0.351.14 (0.87 to 1.50)0.35
 Quintile 256.3–76.7248106168.11.22 (0.89 to 1.67)0.221.16 (0.83 to 1.62)0.371.26 (0.89 to 1.78)0.191.27 (0.90 to 1.78)0.18
 Quintile 376.8–100243100157.72.35 (1.37 to 4.06)0.0022.30 (1.33 to 3.96)0.0032.39 (1.40 to 4.07)0.0012.40 (1.42 to 4.07)0.001
 Quintile 4101–134251121185.91.72 (1.24 to 2.37)0.0011.58 (1.17 to 2.15)0.0031.85 (1.41 to 2.44)<0.0011.86 (1.41 to 2.45)<0.001
 Quintile 5135–682244112177.61.97 (1.39 to 2.80)<0.0011.92 (1.31 to 2.80)<0.0011.92 (1.29 to 2.87)0.0011.92 (1.28 to 2.86)0.001
P trend0.020.030.040.04
  • HR are from models stratified by quintiles of TMAO. In each quintile, HR represents increase in risk per 2-fold increase in TMAO concentrations. Modeled as natural log transformed TMAO/natural log of 2. P-trend represents P value from an interaction between race and quintile indicator variables in a separate model. Model 1 was unadjusted. Model 2 adjusted for age and sex. Model 3 adjusted for variables in Model 2 + ICED severity score, cause of ESRD, body mass index (categorized as <18, 18–25 and >25 kg/m2), systolic BP (categorized as <130, 130–160 and >160 mmHg), albumin, and relative volume removed on dialysis. Model 4 adjusted for variables in Model 3 + residual kidney function (urinary stdKt/VUREA calculated from urinary urea clearance). IR, incidence rate; PY, person years.