Association Between Dialysis Modalities and Risk of Coronary Artery Disease: A Population-Based Cohort Study in Taiwan

Abstract

The hemodynamic effects of hemodialysis (HD) and peritoneal dialysis (PD) on end-stage renal disease (ESRD) patients differ. The influence of dialysis modalities on the cardiovascular system has not been well investigated. We aimed to evaluate the association between dialysis modalities and risk of coronary artery disease (CAD) by using the claim data of Taiwan's Longitudinal Health Insurance Database. This study followed up a cohort of 1624 new onset ESRD patients (≥18 years old), who had started renal replacement therapy during 2000 to 2010; and was followed until 2012. After adjusting for potential confounders, patients who underwent HD had significantly higher risks of incidence of CAD, in comparison with patients who underwent PD (adjusted hazard ratio = 1.47; 95% confidence interval = 1.01-2.11). An increased risk of incident CAD was distinguished in patients receiving HD, compared with those on PD. Further studies are warranted to explore the underlying mechanism and improve dialysis outcomes.

Keywords: Coronary artery diseases; End-stage renal disease; Hemodialysis; Peritoneal dialysis.