Kim, Hyunwook; Kim, Kyoung Hoon; Ahn, Song Vogue; Kang, Shin-Wook; Yoo, Tae-Hyun; Ahn, Hyeong Sik; Hann, Hoo Jae; Lee, Shina; Ryu, Jung-Hwa; Yu, Mina; Kim, Seung-Jung; Kang, Duk-Hee; Choi, Kyu Bok; Ryu, Dong-Ryeol
International journal of cardiology
2015Nov ; 198 ( 9 ) :95-101.
PMID : 26159246
ÀúÀÚ »ó¼¼Á¤º¸
Kim, Hyunwook - Department of Internal Medicine, Wonkwang University College of Medicine Sanbon Hospital, Gunpo, Republic of Korea.
Kim, Kyoung Hoon - Department of Public Health, Graduate School, Korea University, Seoul, Republic of Korea.
Ahn, Song Vogue - Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
Kang, Shin-Wook - Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Yoo, Tae-Hyun - Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Ahn, Hyeong Sik - Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
Hann, Hoo Jae - Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Lee, Shina - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Ryu, Jung-Hwa - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Yu, Mina - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Kim, Seung-Jung - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Kang, Duk-Hee - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Choi, Kyu Bok - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Ryu, Dong-Ryeol - Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. Electronic address drryu@ewha.ac.kr.
ABSTRACT
BACKGROUND: Dialysis patients are at high risk for cardiovascular diseases, but until now there have been no detailed analyses of the incidences among Asian patients initiating dialysis. The aims of this study were to determine the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and to compare them between incident HD patients and PD patients.
METHODS: We included all patients who had started dialysis between January 1, 2005 and December 31, 2008 in Korea, and analyzed 30,279 eligible patients [22,892 hemodialysis (HD) patients and 7387 peritoneal dialysis (PD) patients] by intention-to-treat. Median follow-up was 21.5 months.
RESULTS: The crude incidence rates were as follows: MACCE, 182 per 1000 patient-years (PY); major adverse cardiac events (MACE), 138/1000 PY; all-cause mortality, 116/1000 PY; non-fatal acute myocardial infarction (AMI), 18/1000 PY; target vessel revascularization (TVR), 17/1000 PY; and non-fatal stroke, 60/1000 PY. When comparing all baseline covariate-adjusted relative risks between HD and PD patients, HD is overall superior to PD in terms of MACCE. Further examined by each endpoint, all-cause mortality, non-fatal AMI, and TVR occurred significantly more frequently in patients on PD than in those on HD, whereas non-fatal hemorrhagic stroke occurred significantly more frequently in patients on HD than in those on PD.
CONCLUSIONS: The incidence of MACCE may be different from Western dialysis patients. HD is overall superior to PD in terms of MACCE as an initial dialysis modality. Underlying mechanisms differentially affecting cardiovascular outcomes by dialysis modality remain to be further elucidated. CI - Copyright ??2015 Elsevier Ireland Ltd. All rights reserved.
keyword
Cardiovascular disease; Hemodialysis; Peritoneal dialysis
¸µÅ©