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      Association between Dialysis Modality and Cardiovascular Diseases: A Comparison between Peritoneal Dialysis and Hemodialysis


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          Introduction: In patients with end-stage kidney disease (ESKD), cardiovascular diseases (CVDs) are the most common causes of hospitalization and death. Objective: We aimed to determine the association between dialysis modality and CVDs. Methods: This retrospective observational cohort study compared the emergency hospitalization and mortality of patients with CVDs who underwent peritoneal dialysis (PD) versus hemodialysis (HD). After propensity score matching, the risk factors were evaluated using Cox proportional hazards regression models. Results: A total of 260 patients were matched: 130 of 135 PD (75 men; age, 65.4 years; dialysis vintage, 3.3 years) and 130 of 706 HD (70 men [ p = 0.5]; 66.6 years [ p = 0.4]; dialysis vintage, 3.1 years [ p = 0.5]) patients. Emergency hospitalization rates (hospitalizations/person-years) for overall CVDs (0.138 vs. 0.066, p = 0.002) and pulmonary edema (0.048 vs. 0.019, p = 0.03) were significantly higher in patients who underwent PD than those who underwent HD. The log-rank test revealed that all-cause and CVD mortalities were significantly higher in PD (both p < 0.001). Mortality rates (deaths/person-years) for overall CVDs (0.058 vs. 0.015, p < 0.002), cerebrovascular disease (0.019 vs. 0.004, p = 0.03), and ischemic heart disease (0.010 vs. 0, p = 0.02) were significantly higher in PD. The Cox proportional hazards regression model showed that PD and age were significant predictors of emergency hospitalization (hazard ratio [HR] 2.70; 95% CI 1.53–4.77; p = 0.001) and mortality (HR 4.41; 95% CI 1.66–11.72; p = 0.003) for CVDs. Conclusions: PD is a risk factor for emergency hospitalization and mortality associated with CVDs in dialysis patients with ESKD. Strict control of body fluid balance may prevent cardiovascular events in patients undergoing PD.

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          Author and article information

          Blood Purif
          Blood Purification
          S. Karger AG
          May 2020
          18 December 2019
          : 49
          : 3
          : 302-309
          Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
          Author notes
          *Masataka Banshodani, Department of Artificial Organs, Akane-Foundation, Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima 730-8655 (Japan), E-Mail m-banshodani@tsuchiya-hp.jp
          Author information
          504040 Blood Purif 2020;49:302–309
          © 2019 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 30 July 2019
          : 10 October 2019
          Page count
          Figures: 2, Tables: 3, Pages: 8
          Research Article

          Cardiovascular Medicine,Nephrology
          Peritoneal dialysis,Mortality,Hospitalization,Hemodialysis,Cardiovascular disease


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