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, 38 (4), 490-498

Dialysis Modality-Related Disparities in Sudden Cardiac Death: Hemodialysis Versus Peritoneal Dialysis

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Dialysis Modality-Related Disparities in Sudden Cardiac Death: Hemodialysis Versus Peritoneal Dialysis

Hee-Yeon Jung et al. Kidney Res Clin Pract.

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.

Keywords: Coronary artery disease; Heart failure; Hemodialysis; Hypertension; Peritoneal dialysis; Sudden cardiac death.

Conflict of interest statement

Conflicts of interest

All authors declare no competing interests.

Figures

Figure 1
Figure 1
Percentage of sudden death in different subgroups: hemodialysis (HD) versus peritoneal dialysis (PD). In the entire population, the proportion of sudden In subgroups, the percentage of sudden cardiac death (SCD) in patients on HD was still higher than that in patients on PD who were ≥65 years, < 65 years, male, female, had diabetes, and hypertension. CAD, coronary artery disease; CHF, congestive heart failure; DM, diabetes mellitus; HTN, hypertension.
Figure 2
Figure 2
Different percentages of sudden cardiac death according to the years. In patients on hemodialysis (HD), the proportion of sudden cardiac death (SCD) between 2001 and 2017 was significantly higher than that between 1985 and 2000 (2001–2017 vs. 1985–2000: 22.6 vs. 17.9%, P = 0.008). The proportion of SCD based on the years was not significantly different in patients on peritoneal dialysis (PD).

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