Table 2.

Association of TMAO with outcomes in 1232 patients of the hemodialysis study

OutcomesNEventsIR Per 1000 PYModel 1 UnadjustedModel 2 Adjusted: Age, SexModel 3 Adjusted: Model 2 + Comorbidity + Clinical + LabsModel 4 Model 3 + Residual Kidney Function
HR (95% CI)P ValueHR (95% CI)P ValueHR (95% CI)P ValueHR (95% CI)P Value
Cardiac death
 All patients123221668.01.08 (0.95 to 1.23)0.241.04 (1.03 to 1.04)<0.0011.10 (0.96 to 1.25)0.171.09 (0.96 to 1.24)0.19
 Whites43196101.31.46 (1.28 to 1.66)<0.0011.46 (1.28 to 1.66)<0.0011.46 (1.25 to 1.71)<0.0011.45 (1.24 to 1.69)<0.001
 Blacks80112053.90.92 (0.79 to 1.06)0.250.92 (0.78 to 1.08)0.310.90 (0.77 to 1.06)0.210.90 (0.77 to 1.06)0.20
P value interaction<0.001<0.001<0.001<0.001
Sudden cardiac death
 All patients123212439.11.16 (1.01 to 1.33)0.030.99 (0.82 to 1.20)0.911.17 (1.01 to 1.36)0.041.16 (1.01 to 1.35)0.04
 Whites4315457.01.76 (1.36 to 2.28)<0.0011.75 (1.39 to 2.20)<0.0011.71 (1.34 to 2.18)<0.0011.70 (1.34 to 2.15)<0.001
 Blacks8017031.40.93 (0.79 to 1.08)0.330.93 (0.79 to 1.09)0.380.92 (0.78 to 1.08)0.320.92 (0.78–1.08)0.31
P value interaction<0.001<0.001<0.001<0.001
First cardiovascular event or any cause death
 All patients1148626274.31.05 (0.95 to 1.15)0.350.64 (0.51 to 0.79)<0.0011.05 (0.97 to 1.14)0.201.05 (0.98 to 1.14)0.17
 Whites388220333.01.16 (0.99 to 1.37)0.071.16 (1.00 to 1.34)0.051.15 (1.00 to 1.32)0.041.15 (1.01 to 1.32)0.04
 Blacks760406250.31.01 (0.90 to 1.14)0.871.03 (0.92 to 1.15)0.651.01 (0.92 to 1.10)0.831.01 (0.93 to 1.10)0.80
P value interaction0.180.230.090.09
Any-cause death
 All Patients1232550173.31.02 (0.94 to 1.11)0.571.04 (0.97 to 1.11)0.321.06 (0.98 to 1.14)0.151.06 (0.98 to 1.14)0.15
 Whites431217229.01.16 (1.04 to 1.29)0.011.15 (1.05 to 1.27)0.0031.22 (1.09 to 1.37)<0.0011.22 (1.09 to 1.36)<0.001
 Blacks801333149.50.97 (0.86 to 1.10)0.670.98 (0.85 to 1.12)0.740.97 (0.85 to 1.10)0.650.97 (0.85 to 1.10)0.64
P value interaction0.070.100.020.02
  • HR represents increase in risk per 2-fold increase in TMAO concentrations. Modeled as natural log transformed TMAO/natural log of 2. 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.