A comparison of the risk of congestive heart failure-related hospitalizations in patients receiving hemodialysis and peritoneal dialysis - A retrospective propensity score-matched study


Autoři: Chien-Yao Sun aff001;  Junne-Ming Sung aff001;  Jung-Der Wang aff001;  Chung-Yi Li aff002;  Yi-Ting Kuo aff001;  Chia-Chun Lee aff001;  Jia-Ling Wu aff001;  Yu-Tzu Chang aff001
Působiště autorů: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan aff001;  Department of Public Health, National Cheng Kung University, College of Medicine, Tainan, Taiwan aff002;  Department of Environmental and Occupational Health, National Cheng Kung University Hospital, Tainan, Taiwan aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223336

Souhrn

Introduction

Congestive heart failure (CHF) is associated with high mortality and a heavy financial and healthcare burden in the dialysis population. Determining which dialysis modality is associated with a higher risk of developing CHF might facilitate clinical decision making and surveillance programs in the dialysis population.

Methods

Using the Taiwan National Health Insurance Database, we recruited all incident dialysis patients during the period from January 1, 1998 to December 31, 2010. The propensity score matching method was applied to establish the matched hemodialysis (HD) and peritoneal dialysis (PD) cohort. Incidence rates and cumulative incidence rates of CHF-related hospitalization were first compared for the HD and PD patients. Multivariable subdistribution hazards models were then constructed to control for potential confounders.

Results

Among a total of 65,899 enrolled dialysis patients, 4,754 matched pairs of HD and PD patients were identified. The incidence rates of CHF in the matched HD and PD patients were 25.98 and 19.71 per 1000 patient-years, respectively (P = 0.001). The cumulative incidence rate of CHF was also higher in the matched HD patients (0.16, 95% confidence interval (CI)(0.12–0.21)] than in the corresponding PD patients (0.09, 95% CI [0.08–0.11])(P<0.0001). HD was consistently associated with an increased subdistribution hazard ratio (HR) of CHF compared with PD in the matched cohort (HR: 1.45, 95% CI [1.23–1.7]). Similar phenomenons were observed in either the subgroup analysis stratified by selected confounders or in the HD and PD group without matching.

Conclusions

HD is associated with a higher risk of developing CHF-related hospitalization than PD. The surveillance program for CHF should differ in patients receiving different dialysis modalities.

Klíčová slova:

Cardiology – Coronary heart disease – Heart failure – Hyperlipidemia – Chronic kidney disease – Medical dialysis – Medical risk factors – Taiwan


Zdroje

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PLOS One


2019 Číslo 10

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