I-Kuan Wang1, Chi-Yu Lu2, Cheng-Li Lin3, Chih-Chia Liang4, Tzung-Hai Yen5, Yao-Lung Liu4, Fung-Chang Sung6. 1. Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Department of Internal Medicine, China Medical University College of Medicine, Taichung, Taiwan; Division of Nephrology, China Medical University Hospital, Taichung, Taiwan. 2. Department of Biochemistry, College of Medicine Kaohsiung Medical University, Kaohsiung, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 4. Division of Nephrology, China Medical University Hospital, Taichung, Taiwan. 5. Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan. 6. Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. Electronic address: fcsung1008@yahoo.com.
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.
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 ESRDpatients 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 HDpatients, compared to PDpatients. CONCLUSIONS: No difference was observed in the overall risk of de novo major ischemic heart events between HD and PDpatients. However, HD was associated with a higher risk of de novo CHF than PD in the first year under dialysis treatment.
Authors: Kai-Uwe Eckardt; Nisha Bansal; Josef Coresh; Marie Evans; Morgan E Grams; Charles A Herzog; Matthew T James; Hiddo J L Heerspink; Carol A Pollock; Paul E Stevens; Manjula Kurella Tamura; Marcello A Tonelli; David C Wheeler; Wolfgang C Winkelmayer; Michael Cheung; Brenda R Hemmelgarn Journal: Kidney Int Date: 2018-04-12 Impact factor: 10.612