Association of dialysis modality and cardiovascular mortality in incident dialysis patients

Johnson, David W., Dent, Hannah, Hawley, Carmel M., McDonald, Stephen P., Rosman, Johan B., Brown, Fiona G., Bannister, Kym and Wiggins, Kathryn J. (2009) Association of dialysis modality and cardiovascular mortality in incident dialysis patients. Clinical Journal of the American Society of Nephrology, 4 10: 1620-1628. doi:10.2215/CJN.01750309

Author Johnson, David W.
Dent, Hannah
Hawley, Carmel M.
McDonald, Stephen P.
Rosman, Johan B.
Brown, Fiona G.
Bannister, Kym
Wiggins, Kathryn J.
Title Association of dialysis modality and cardiovascular mortality in incident dialysis patients
Journal name Clinical Journal of the American Society of Nephrology   Check publisher's open access policy
ISSN 1555-9041
Publication date 2009-10-01
Sub-type Article (original research)
DOI 10.2215/CJN.01750309
Open Access Status Not Open Access
Volume 4
Issue 10
Start page 1620
End page 1628
Total pages 9
Place of publication Washington, DC, United States
Publisher American Society of Nephrology
Language eng
Formatted abstract
Background and objectives: The aim of the investigation presented here was to compare the rates, causes, and timing of cardiovascular (CV) death in incident peritoneal dialysis (PD) and hemodialysis (HD) patients.

Design, setting, participants, & measurements: The study included all adult Australian and New Zealand patients commencing dialysis between January 1, 1997 and December 31, 2007. Rates of and times to CV death were compared by incident rate ratios, cumulative incidence, and multivariable Cox proportional hazards model analyses. Dialysis modality was included in the model as a time-varying covariate, and a competing risks approach was used to obtain cause-specific hazard ratios.

Results: Of the 24,587 patients who commenced dialysis (first treatment PD n = 6521; HD n = 18,066) during the study, 5669 (21%) died from CV causes [PD 2044 (28%) versus HD 3625 (21%)]. The incidence rates of CV mortality in PD and HD patients were 9.99 and 7.96 per 100 patient-years, respectively (incidence rate ratio PD versus HD, 1.25; 95% confidence interval 1.12 to 1.32). PD was consistently associated with an increased hazard of CV death compared with HD after 1 yr of treatment. This increased risk in PD patients was largely accounted for by an increased risk of death due to myocardial infarction.

Dialysis modality is significantly associated with the risk, causes, and timing of CV death experienced by ESRD patients in Australia and New Zealand.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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