Kidney Res Clin Pract.  2019 Dec;38(4):490-498. 10.23876/j.krcp.19.034.

Dialysis modality-related disparities in sudden cardiac death: hemodialysis versus peritoneal dialysis

• Jung HY
• Choi H
• Choi JY
• Cho JH
• Park SH
• Kim CD
• Ryu DR
• Kim YL
• the ESRD Registry Committee of the Korean Society of Nephrology

• KMID: 2469379
• DOI: http://doi.org/10.23876/j.krcp.19.034

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.

Keyword

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

MeSH Terms

Comorbidity
Coronary Artery Disease
Death, Sudden, Cardiac*
Dialysis*
Follow-Up Studies
Heart Failure
Humans
Hypertension
Incidence
Kidney Failure, Chronic
Nephrology
Peritoneal Dialysis*
Renal Dialysis*
Risk Factors