Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct;4(10):1620-8.
doi: 10.2215/CJN.01750309. Epub 2009 Sep 3.

Association of dialysis modality and cardiovascular mortality in incident dialysis patients

David W Johnson  1 , Hannah Dent, Carmel M Hawley, Stephen P McDonald, Johan B Rosman, Fiona G Brown, Kym Bannister, Kathryn J Wiggins
Affiliations

Association of dialysis modality and cardiovascular mortality in incident dialysis patients

David W Johnson et al. Clin J Am Soc Nephrol. 2009 Oct.

Abstract

Background and objectives: The aim of the investigation presented here was to compare the rates, causes, and timing of cardiovascular (CV) death in incident peritoneal dialysis (PD) and hemodialysis (HD) patients.

Design, setting, participants, & measurements: The study included all adult Australian and New Zealand patients commencing dialysis between January 1, 1997 and December 31, 2007. Rates of and times to CV death were compared by incident rate ratios, cumulative incidence, and multivariable Cox proportional hazards model analyses. Dialysis modality was included in the model as a time-varying covariate, and a competing risks approach was used to obtain cause-specific hazard ratios.

Results: Of the 24,587 patients who commenced dialysis (first treatment PD n = 6521; HD n = 18,066) during the study, 5669 (21%) died from CV causes [PD 2044 (28%) versus HD 3625 (21%)]. The incidence rates of CV mortality in PD and HD patients were 9.99 and 7.96 per 100 patient-years, respectively (incidence rate ratio PD versus HD, 1.25; 95% confidence interval 1.12 to 1.32). PD was consistently associated with an increased hazard of CV death compared with HD after 1 yr of treatment. This increased risk in PD patients was largely accounted for by an increased risk of death due to myocardial infarction.

Conclusions: Dialysis modality is significantly associated with the risk, causes, and timing of CV death experienced by ESRD patients in Australia and New Zealand.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative incidence with 95% confidence bands of deaths in PD and HD patients from CVD.
Figure 2.
Figure 2.
Hazard ratios (PD versus HD) with 95% confidence bars of cardiovascular deaths in nonindigenous patients by BMI.
Figure 3.
Figure 3.
Cumulative incidence with 95% confidence bands of deaths in PD and HD patients from (A) ischemic heart disease, (B) sudden cardiac death, (C) cardiac failure, and (D) cerebrovascular disease.
See this image and copyright information in PMC

References

    1. McDonald S, Excell L: ANZDATA Registry Report 2005. Adelaide, South Australia, Australian and New Zealand Dialysis and Transplant Registry, 2006
    1. Annual Data Report Minneapolis, MN, U.S. Renal Data Systems, 2006
    1. Foley RN, Parfrey PS, Sarnak MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32: S112– S119, 1998 - PubMed
    1. Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, Salem DN, Levey AS, Sarnak MJ: Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: A pooled analysis of community-based studies. J Am Soc Nephrol 15: 1307– 1315, 2004 - PubMed
    1. Keough-Ryan TM, Kiberd BA, Dipchand CS, Cox JL, Rose CL, Thompson KJ, Clase CM: Outcomes of acute coronary syndrome in a large Canadian cohort: Impact of chronic renal insufficiency, cardiac interventions, and anemia. Am J Kidney Dis 46: 845– 855, 2005 - PubMed

Publication types