Key result
Hydralazine-isosorbide dinitrate use in maintenance dialysis patients with heart failure was associated with lower all-cause mortality (16.0 vs 27.9 events/100 PYs; HR 0.48, 95% CI 0.43-0.54).
Why the study?
Hydralazine-isosorbide dinitrate has potential as a heart failure therapy in the setting of maintenance dialysis, but its efficacy needed evaluation.
Does hydralazine-isosorbide dinitrate reduce all-cause mortality in adult patients with heart failure on maintenance dialysis?
Population
Adult patients with HF on maintenance dialysis (6306 treated with H-ISDN and 75,509 nonusers)
Comparison
H-ISDN use vs nonuse
Design
Retrospective study
Authors
Loading...
Should not yet change practice in dialysis patients with heart failure; leaves open confirmation of mortality benefit in randomized trials.
Cohort (n=81,815)
Yes
Does hydralazine-isosorbide dinitrate reduce all-cause mortality in adult patients with heart failure on maintenance dialysis?
Hazard Ratio: 0.48 (95% CI 0.43–0.54)
Absolute Event Rate: 16% vs 27.9%
In patients with heart failure on maintenance dialysis, hydralazine-isosorbide dinitrate use is associated with significantly lower all-cause and cardiovascular mortality, despite higher rates of HF admission and MI.
Mavrakanas et al. (2022) conducted a cohort in Heart failure in end-stage kidney disease on maintenance dialysis (n=81,815). Hydralazine-isosorbide dinitrate (H-ISDN) vs. Nonusers was evaluated on Death from any cause (HR 0.48, 95% CI 0.43-0.54). Hydralazine-isosorbide dinitrate use in maintenance dialysis patients with heart failure was associated with lower all-cause mortality (16.0 vs 27.9 events/100 PYs; HR 0.48, 95% CI 0.43-0.54).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: