Heart failure risk higher with hemodialysis vs peritoneal dialysis

  • Sun CY & al.
  • PLoS One
  • 01/01/2019

  • Yael Waknine
  • Clinical Essentials
L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano L'accesso ai contenuti di questo sito è riservato agli operatori del settore sanitario italiano

Takeaway

  • Risk for congestive heart failure (CHF)-related hospitalization is higher with hemodialysis vs peritoneal dialysis.

Why this matters

  • Findings warrant more careful surveillance of hemodialysis-dependent patients.

Study design

  • 4754 propensity-matched pairs of patients undergoing hemodialysis and peritoneal dialysis, derived from an overall cohort of 65,899 dialysis patients from the Taiwan National Health Insurance Database (1998-2010).
  • Endpoint: CHF symptoms requiring hospitalization.
  • Funding: National Cheng-Kung University Hospital, Tainan, Taiwan. 

Key results

  • Crude CHF incidence rate was significantly higher with hemodialysis vs peritoneal dialysis (25.98 vs 19.71 per 1000 patient-years; P<.001 style="list-style-type:circle;">
  • Incidence increased with age in both sexes.
  • Cumulative CHF incidence was likewise higher with hemodialysis (0.16 [95% CI, 0.12-0.21] vs 0.09 [95% CI, 0.08-0.11]; P<.0001>
  • In multivariate analysis, risk for CHF was 45% higher with hemodialysis vs peritoneal dialysis (aHR=1.45; 95% CI, 1.23-1.70).
    • Results were similar in the overall cohort (aHR=1.54; 95% CI, 1.35-1.75).
  • Age-specific analysis found a higher relative CHF risk in patients aged ≥60 years (aHR=2.04; 95% CI, 1.50-2.79) than those aged

    Limitations

    • Clinical trial vs real-world data.
    • Detailed risk factor data were not captured.
    • Asian population.