Dialysis modality-related disparities in sudden cardiac death: hemodialysis versus peritoneal dialysis

다국어 초록 (Multilingual Abstract)

Background: Patients require risk stratification and preventive strategies for sudden cardiac death (SCD) based on the dialysis modality because the process of dialysis is a risk factor for SCD. This study aimed to compare the risk of SCD in patients undergoing hemodialysis (HD) versus peritoneal dialysis (PD).
Methods: Patients on HD and PD were included in the end-stage renal disease registry of the Korean Society of Nephrology between 1985 and 2017. The incidence and associated factors of SCD were analyzed based on the dialysis modality.
Results: Of 132,083 patients, 34,632 (26.2%) died during 94.8 ± 73.6 months of follow-up. In patients on HD and PD, 22.2% and 19.6% of total deaths were SCDs. In the propensity score-matched population, SCD accounted for 21.7% and 19.6% of total deaths in patients on HD and PD, respectively. HD was independently associated with SCD even after adjusting for age and significant comorbidities. Hypertension, coronary artery disease, and congestive heart failure, and age at the time of death < 65 years were independent risk factors for SCD in patients on HD but not in those on PD. Diabetes was significantly associated with SCD regardless of the dialysis modality.
Conclusion: Compared with patients on PD, Korean patients on HD have a higher risk of SCD, which is attributable to cardiac comorbidities.

참고문헌 (Reference)

1 Paoletti E, "The worsening of left ventricular hypertrophy is the strongest predictor of sudden cardiac death in haemodialysis patients : a 10 year survey" 19 : 1829-1834, 2004

2 Genovesi S, "Sudden death in end stage renal disease : comparing hemodialysis versus peritoneal dialysis" 44 : 77-88, 2017

3 Takeda K, "Sudden death in chronic dialysis patients" 12 : 952-955, 1997

4 Zheng ZJ, "Sudden cardiac death in the United States, 1989 to 1998" 104 : 2158-2163, 2001

5 Makar MS, "Sudden cardiac death among hemodialysis patients" 69 : 684-695, 2017

6 Flythe JE, "Rapid fluid removal during dialysis is associated with cardiovascular morbidity and mortality" 79 : 250-257, 2011

7 Lafrance JP, "Predictors and outcome of cardiopulmonary resuscitation(CPR)calls in a large haemodialysis unit over a seven-year period" 21 : 1006-1012, 2006

8 Davis TR, "Outcome of cardiac arrests attended by emergency medical services staff at community outpatient dialysis centers" 73 : 933-939, 2008

9 Singh N, "Myocardial alterations during hemodialysis : insights from new noninvasive technology" 14 : 173-181, 1994

10 Pun PH, "Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics" 79 : 218-227, 2011

11 Jadoul M, "Modifiable practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns study" 7 : 765-774, 2012

12 Foley RN, "Long interdialytic interval and mortality among patients receiving hemodialysis" 365 : 1099-1107, 2011

13 진동찬, "Lessons from 30 years’ data of Korean end-stage renal disease registry, 1985–2015" 대한신장학회 34 (34): 132-139, 2015

14 Zuber M, "Incidence of arrhythmias and myocardial ischaemia during haemodialysis and haemofiltration" 4 : 632-634, 1989

15 McIntyre CW, "Effects of hemodialysis on cardiac function" 76 : 371-375, 2009

16 Pun PH, "Dialysate calcium concentration and the risk of sudden cardiac arrest in hemodialysis patients" 8 : 797-803, 2013

17 Krishnasamy R, "Daily variation in death in patients treated by long-term dialysis : comparison of in-center hemodialysis to peritoneal and home hemodialysis" 61 : 96-103, 2013

18 Bleyer AJ, "Characteristics of sudden death in hemodialysis patients" 69 : 2268-2273, 2006

19 Cheung AK, "Cardiac diseases in maintenance hemodialysis patients : results of the HEMO Study" 65 : 2380-2389, 2004

20 Karnik JA, "Cardiac arrest and sudden death in dialysis units" 60 : 350-357, 2001

21 Wanner C, "Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis" 353 : 238-248, 2005

22 Movilli E, "Association between high ultrafiltration rates and mortality in uraemic patients on regular haemodialysis. A 5-year prospective observational multicentre study" 22 : 3547-3552, 2007