Key result
Hemodialysis was associated with a higher risk of sudden cardiac death compared to peritoneal dialysis in patients with end-stage renal disease.
Why the study?
Risk stratification and preventive strategies for sudden cardiac death (SCD) based on dialysis modality are needed, prompting a comparison of SCD risk between hemodialysis and peritoneal dialysis.
Does hemodialysis increase the risk of sudden cardiac death compared to peritoneal dialysis in patients with end-stage renal disease?
Cohort (n=132,083)
Yes
Does hemodialysis increase the risk of sudden cardiac death compared to peritoneal dialysis in patients with end-stage renal disease?
In patients with end-stage renal disease, hemodialysis is associated with a higher risk of sudden cardiac death compared to peritoneal dialysis, particularly in those with underlying cardiac comorbidities.
Answers are grounded in this paper and cite their sources.
May warrant caution selecting hemodialysis in ESRD patients with cardiac risk; leaves open need for randomized confirmation of modality-specific SCD risk.
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.
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Jung et al. (2019) conducted a cohort in End-stage renal disease (ESRD) (n=132,083). Hemodialysis vs. Peritoneal dialysis was evaluated on Sudden cardiac death (SCD) as a proportion of total deaths (OR 1.15, 95% CI 1.08-1.23, p=<0.001). Hemodialysis was associated with a higher risk of sudden cardiac death compared to peritoneal dialysis in patients with end-stage renal disease.
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