Comparison of the risk of de novo cardiovascular disease between hemodialysis and peritoneal dialysis in patients with end-stage renal disease.

Abstract

BACKGROUND:

The purpose of the study was to compare the risk of de novo cardiovascular disease (CVD) between hemodialysis (HD) and peritoneal dialysis (PD) in patients with incident end-stage renal disease (ESRD).

METHODS:

From a Taiwanese universal insurance claims database, we identified 45309 incident ESRD patients without preexisting CVD from 2000 to 2010. Using the propensity score matching method, we included 6516 patients in HD and PD groups, respectively. All patients were followed up until the end of 2011. The Cox proportional hazards regression model was employed to calculate the impact of dialysis modality on the risk of new onset cardiovascular events including ischemic heart disease, and congestive heart failure (CHF).

RESULTS:

No difference was observed in the overall risk of de novo ischemic heart disease between the propensity score-matched HD and PD groups (HD versus PD, adjusted hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 0.86-1.22). However, HD was associated with a higher risk of de novo CHF (adjusted HR: 1.29, 95% CI: 1.13-1.47) than PD was. The risk of de novo CHF was particularly high in the first year under dialysis treatment for propensity score-matched HD patients, compared to PD patients.

CONCLUSIONS:

No difference was observed in the overall risk of de novo major ischemic heart events between HD and PD patients. However, HD was associated with a higher risk of de novo CHF than PD in the first year under dialysis treatment.

• Authors: I-Kuan Wang, Chi-Yu Lu, Cheng-Li Lin, Chih-Chia Liang, Tzung-Hai Yen, Yao-Lung Liu, Fung-Chang Sung
• Journal: International journal of cardiology (Int J Cardiol) Vol. 218 Pg. 219-224 (Sep 01 2016) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 27236118 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Cardiovascular Diseases (epidemiology)
• Female
• Hemodiafiltration (adverse effects)
• Humans
• Insurance Claim Review
• Kidney Failure, Chronic (therapy)
• Male
• Middle Aged
• Peritoneal Dialysis (adverse effects)
• Propensity Score
• Proportional Hazards Models
• Taiwan (epidemiology)